Beacon Medical Group Specialists Main Suite 100

LBN: Beacon Medical Group, Inc.
Beacon Medical Group Specialists Main Suite 100 is an health care organization with primary practice located at 6913 N Main St Ste 100 , Granger IN 46530. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism. Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism is the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 647-6400, or through Costello, Jeffrey via phone (574) 647-3549.

Contact Information

Primary practice address
6913 N Main St Ste 100 Granger IN 46530
Phone: (574) 647-6400
Fax: (574) 647-2951
Website:
Map and Directions
Authorized official contact:
Name: Costello, Jeffrey
Phone: (574) 647-3549

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X

Profile Details

NPI number 1306899554
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group Specialists Main Suite 100
Authorized official Costello, Jeffrey
Entity Organization
Organization subpart 1 No
Enumeration date May 18th, 2006
Last updated Dec 9th, 2019 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306899554 NPPES
Indiana MEDICAID 100224050D

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