Provider Demographics
NPI:1649434010
Name:BROWNSTONE FINANCIAL GROUP
Entity type:Organization
Organization Name:BROWNSTONE FINANCIAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRUDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-826-4242
Mailing Address - Street 1:3577A CHAMBER TUCKER RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341
Mailing Address - Country:US
Mailing Address - Phone:770-826-4242
Mailing Address - Fax:
Practice Address - Street 1:1770 INDIAN TRAIL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-2645
Practice Address - Country:US
Practice Address - Phone:770-826-4242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6148930001Medicare NSC