Nickalaus David Bryce, PHARMD
Individual provider Active NPI Pharmacist · Willcox, AZ
NPI 1578680922 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1578680922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 15445 (AZ)
- Practice address
- 650 N Bisbee Ave
Willcox, AZ 85643-1437 - Phone
- (520) 384-4612
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15445 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| N & R Bryce Enterprises LLC | Current | Accepting new patients | |
| N & R Bryce Enterprises LLC | Current | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15445 | AZ | Yes |
Addresses
Primary practice location
650 N Bisbee Ave
Willcox, AZ 85643-1437
Mailing address
490 W Smith St
Saint David, AZ 85630-6133
Phone (520) 720-2629
Other providers in Willcox, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.