Provider Demographics
NPI:1417513904
Name:N & R BRYCE ENTERPRISES LLC
Entity type:Organization
Organization Name:N & R BRYCE ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NICKALAUS
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BRYCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:928-537-8555
Mailing Address - Street 1:PO BOX 1569
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85902-1569
Mailing Address - Country:US
Mailing Address - Phone:928-537-8555
Mailing Address - Fax:928-537-9555
Practice Address - Street 1:2841 HIGHWAY 260 SUITE 2
Practice Address - Street 2:
Practice Address - City:OVERGAARD
Practice Address - State:AZ
Practice Address - Zip Code:85933
Practice Address - Country:US
Practice Address - Phone:928-537-8555
Practice Address - Fax:928-537-9555
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:N & R BRYCE ENTERPRISES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy