Provider Demographics
NPI:1609024397
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 & PRESIDENT
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:732-302-1600
Mailing Address - Street 1:PO BOX 277596
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-7596
Mailing Address - Country:US
Mailing Address - Phone:770-422-5516
Mailing Address - Fax:770-590-8563
Practice Address - Street 1:19820 N CREEK PKWY STE 100
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-8227
Practice Address - Country:US
Practice Address - Phone:800-456-3500
Practice Address - Fax:877-354-4795
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BYRAM HOLDINGS I, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1609024397Medicaid
ID808148700Medicaid
WA9062209Medicaid
WA9062217Medicaid
HI630716Medicaid
CADME03066FMedicaid
AKMS332WAMedicaid
WA9062225Medicaid
WA0228430012Medicare NSC