Organization
N & R BRYCE ENTERPRISES LLC
Active
Other names
White Mountain Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NICKALAUS DAVID BRYCE PHARMD (MANAGING MEMBER)
(928) 243-0566
Entity
Organization
Contact information
Practice address
4461 S WHITE MOUNTAIN RD STE D2, SHOW LOW, AZ 85901-7783
(928) 537-8555
(928) 537-9555
Mailing address
PO BOX 919, TAYLOR, AZ 85939-0919
(928) 537-8555
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
08/01/2017
Last updated
10/17/2017
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