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General NPI Number Information
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NPI Number | 1730558115
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Entity Type | Organization
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Legal Business Name | BYRAM HEALTHCARE CENTERS, INC.
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 04/29/2016
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Provider Practice Location Address
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Address Line | 3793 S STATE ST
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-4828
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Country | US
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Telephone | 801-716-8797
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Fax | 866-478-9348
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Provider Business Mailing Address
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Address Line | 3793 S STATE ST
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City | SALT LAKE CITY
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State | UT
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Zip | 84115-4828
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Country | US
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Telephone | 801-716-8797
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Fax | 866-478-9348
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Authorized Official
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Title or Position | CEO
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Name | PERRY A BERNOCCHI
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Credential |
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Telephone | 714-895-6416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 9623310-1703
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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