Beacon Medical Group- Trauma And Surgical Services
LBN: Beacon Medical Group, Inc.
Beacon Medical Group- Trauma And Surgical Services is an health care organization with primary practice located at 621 Memorial Dr Ste 502 , South Bend IN 46601-1075. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Trauma Surgery is the primary health care specialty.
Beacon Medical Group, Inc. can be contacted via phone (574) 647-5875, or through Costello, Jeffrey P. via phone (574) 647-3549.
Contact Information
Primary practice address
621 Memorial Dr Ste 502
South Bend IN 46601-1075
Phone: (574) 647-5875
Fax: (574) 647-5878
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | ||
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | ||
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X |
Profile Details
| NPI number | 1174927131 |
|---|---|
| LBN Legal business name | Beacon Medical Group, Inc. |
| DBA Doing business as | Beacon Medical Group- Trauma And Surgical Services |
| Authorized official | Costello, Jeffrey P. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 20th, 2014 |
| Last updated | Apr 24th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174927131 | NPPES |
| Indiana | MEDICAID | 200921930E |
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