Provider Demographics
NPI:1417241928
Name:BYRAMS HOMECARE, LLC
Entity Type:Organization
Organization Name:BYRAMS HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DETRON
Authorized Official - Middle Name:LONNEIL
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-942-6861
Mailing Address - Street 1:401 HAWTHORNE LN
Mailing Address - Street 2:STE 110-281
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2484
Mailing Address - Country:US
Mailing Address - Phone:704-777-4749
Mailing Address - Fax:704-248-0418
Practice Address - Street 1:5736 N TRYON ST
Practice Address - Street 2:STE 201F
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-6850
Practice Address - Country:US
Practice Address - Phone:704-777-4749
Practice Address - Fax:704-248-0418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4372251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health