Beacon Medical Group Southeast Neighborhood Health Center

LBN: Beacon Medical Group, Inc.
Beacon Medical Group Southeast Neighborhood Health Center is an health care organization with primary practice located at 1708 High St , South Bend IN 46613-2633. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 647-1400, or through Costello, Jeffrey via phone (574) 647-3549.

Contact Information

Primary practice address
1708 High St South Bend IN 46613-2633
Phone: (574) 647-1400
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Costello, Jeffrey
Phone: (574) 647-3549

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01059718A Indiana

Profile Details

NPI number 1437100161
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group Southeast Neighborhood Health Center
Authorized official Costello, Jeffrey
Entity Organization
Organization subpart 1 No
Enumeration date May 15th, 2006
Last updated Aug 29th, 2016 - about 10 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 1437100161 NPPES
Indiana MEDICAID 200114230A

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