Provider Demographics
NPI:1326285859
Name:THE BRIAN ALLIANCE (PLLP)
Entity Type:Organization
Organization Name:THE BRIAN ALLIANCE (PLLP)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:FUHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:406-363-9028
Mailing Address - Street 1:POB 2335
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-4335
Mailing Address - Country:US
Mailing Address - Phone:406-363-9028
Mailing Address - Fax:406-363-9028
Practice Address - Street 1:116 N 9TH ST.
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840
Practice Address - Country:US
Practice Address - Phone:406-363-9028
Practice Address - Fax:406-363-9028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN009494163W00000X
MTRN015669163W00000X
MTRN010012163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT380052Medicaid