Beacon Medical Group Middlebury

LBN: Beacon Medical Group, Inc.
Beacon Medical Group Middlebury is an health care organization with primary practice located at 206 W Warren St , Middlebury IN 46540-9410. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 825-2146, or through Costello, Jeffrey P. via phone (574) 647-3549.

Contact Information

Primary practice address
206 W Warren St Middlebury IN 46540-9410
Fax: (574) 524-7435
Website:
Authorized official contact:
Name: Costello, Jeffrey P.

Profile Details

NPI number 1114363835
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group Middlebury
Authorized official Costello, Jeffrey P.
Entity Organization
Organization subpart 1 No
Enumeration date May 21st, 2013
Last updated Mar 4th, 2024 - about 2 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 1114363835 NPPES
Indiana MEDICAID 100114000G

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