<Unavail>
LBN: Beacon Medical Group, Inc.
<Unavail> is an health care organization with primary practice located at 1506 Osolo Rd Suite A, Elkhart IN 46514-4122. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty.
Beacon Medical Group, Inc. can be contacted via phone (574) 523-3347, or through Costello, Jeffrey P via phone (574) 647-3549.
Contact Information
Primary practice address
1506 Osolo Rd Suite A
Elkhart IN 46514-4122
Phone: (574) 523-3347
Fax: (574) 206-9502
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | 06-005017-1 | Indiana |
Profile Details
| NPI number | 1538265863 |
|---|---|
| LBN Legal business name | Beacon Medical Group, Inc. |
| DBA Doing business as | <Unavail> |
| Authorized official | Costello, Jeffrey P |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 15th, 2006 |
| Last updated | Oct 27th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538265863 | NPPES |
| Indiana | Other | 000000110756 | ANTHEM BCBS |
| Indiana | Other | 000000075060 | ANTHEM BCBS |
| Indiana | MEDICAID | 100268350A | ANTHEM BCBS |
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