Healthcare Provider Details

I. General information

NPI: 1609024397
Provider Name (Legal Business Name): BYRAM HEALTHCARE CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19820 N CREEK PKWY STE 100
BOTHELL WA
98011-8227
US

IV. Provider business mailing address

PO BOX 277596
ATLANTA GA
30384-7596
US

V. Phone/Fax

Practice location:
  • Phone: 800-456-3500
  • Fax: 877-354-4795
Mailing address:
  • Phone: 770-422-5516
  • Fax: 770-590-8563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1609024397
Identifier TypeMEDICAID
Identifier StateMT
Identifier Issuer
# 2
Identifier808148700
Identifier TypeMEDICAID
Identifier StateID
Identifier Issuer
# 3
Identifier9062209
Identifier TypeMEDICAID
Identifier StateWA
Identifier Issuer
# 4
Identifier9062217
Identifier TypeMEDICAID
Identifier StateWA
Identifier Issuer
# 5
Identifier630716
Identifier TypeMEDICAID
Identifier StateHI
Identifier Issuer
# 6
IdentifierDME03066F
Identifier TypeMEDICAID
Identifier StateCA
Identifier Issuer
# 7
IdentifierMS332WA
Identifier TypeMEDICAID
Identifier StateAK
Identifier Issuer
# 8
Identifier9062225
Identifier TypeMEDICAID
Identifier StateWA
Identifier Issuer

VIII. Authorized Official

Name: PERRY A BERNOCCHI
Title or Position: CEO & PRESIDENT
Credential:
Phone: 732-302-1600