N & R Bryce Enterprises LLC
Organization Active NPI Community/Retail Pharmacy · Overgaard, AZ
NPI 1417513904 · NPPES record last updated May 10, 2019
Key facts
- NPI
- 1417513904
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- N & R BRYCE ENTERPRISES LLC
- Practice address
- 2841 Highway 260 Suite 2
Overgaard, AZ 85933 - Phone
- (928) 537-8555
- Fax
- (928) 537-9555
- NPI assigned
- May 10, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- N & R BRYCE ENTERPRISES LLC
Authorized official
- Name
- Nickalaus David Bryce, PHARMD
- Title
- Managing Member
- Phone
- (928) 537-8555
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 1
Practitioners 1
-
Nickalaus David Bryce, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151023000214 | AZ | Part B Supplier - Mass Immunization (Roster Biller Only) | 0840509311 |
2 other NPIs on this enrollment Practice locations: Overgaard, AZ |
National Provider Directory
- Part of
- N R Bryce Enterprises LLC
Locations
4461 S White Mountain Rd
Ste D2
Show Low, AZ 85901
Phone (928) 537-8555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
2841 Highway 260 Suite 2
Overgaard, AZ 85933
Mailing address
PO Box 1569
Show Low, AZ 85902-1569
Phone (928) 537-8555
Other names
- White Mountain Pharmacy 2
Other providers in Overgaard, AZ
- Marshall M. Willis D.C., P.C.
- Mitchell F Horan MD PC
- Mogollon Family Dentistry
- Mogollon Family Dentistry
- Mountain Top Transport Services, LLC
- Jennifer Smith Owens
- Kimberly Jo Potter
- Doris Virginia Reeves
- Ryan C Stuart OD PC
- Snowy Mountain Counselling LLC
All providers in Overgaard, AZ · Community/Retail Pharmacy in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.