Provider Demographics
NPI:1699196642
Name:BRYCE HOSPITAL PHARMACY
Entity Type:Organization
Organization Name:BRYCE HOSPITAL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMMISSIONER
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-242-3640
Mailing Address - Street 1:200 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-1250
Mailing Address - Country:US
Mailing Address - Phone:205-759-0677
Mailing Address - Fax:205-759-0681
Practice Address - Street 1:200 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-1250
Practice Address - Country:US
Practice Address - Phone:205-759-0677
Practice Address - Fax:205-759-0681
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALABAMA DEPARTMENT OF MENTAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital