Memorial Children'S Hospital Navarre Pediatrics

LBN: Beacon Medical Group
Memorial Children'S Hospital Navarre Pediatrics is an health care organization with primary practice located at 100 Navarre Pl Suite 4400, South Bend IN 46601-1156. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as the primary health care specialty. Beacon Medical Group can be contacted via phone (574) 647-4535, or through Costello, Jeffrey via phone (574) 647-3549.

Contact Information

Primary practice address
100 Navarre Pl Suite 4400 South Bend IN 46601-1156
Phone: (574) 647-4535
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Costello, Jeffrey
Phone: (574) 647-3549

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 01024987A Indiana

Profile Details

NPI number 1689627812
LBN Legal business name Beacon Medical Group
DBA Doing business as Memorial Children'S Hospital Navarre Pediatrics
Authorized official Costello, Jeffrey
Entity Organization
Organization subpart 1 No
Enumeration date May 18th, 2006
Last updated Mar 9th, 2016 - about 8 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 1689627812 NPPES
Indiana Other 15D1038973 CLIA NUMBER

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