Provider Demographics
NPI:1730558115
Name:BYRAM HEALTHCARE CENTERS, INC.
Entity type:Organization
Organization Name:BYRAM HEALTHCARE CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERNOCCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-895-6416
Mailing Address - Street 1:3793 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-4828
Mailing Address - Country:US
Mailing Address - Phone:801-716-8797
Mailing Address - Fax:866-478-9348
Practice Address - Street 1:3793 S STATE ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84115-4828
Practice Address - Country:US
Practice Address - Phone:801-716-8797
Practice Address - Fax:866-478-9348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9623310-17033336C0003X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy