Provider Demographics
NPI:1053366708
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:MR
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 1:4900 CREEKSIDE DR STE M
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-4041
Practice Address - Country:US
Practice Address - Phone:727-540-0221
Practice Address - Fax:727-540-0161
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BYRAM HOLDINGS I, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-23
Last Update Date:2012-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148362003Medicaid
TX148362002Medicaid
TN1508583Medicaid
0228430002Medicare NSC