Beacon Medical Group Goshen
LBN: Beacon Medical Group, Inc.
Beacon Medical Group Goshen is an health care organization with primary practice located at 2120 Rieth Blvd Ste A , Goshen IN 46526-5858. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Beacon Medical Group, Inc. can be contacted via phone (574) 875-5126, or through Costello, Jeffrey P via phone (574) 647-3549.
Contact Information
Primary practice address
2120 Rieth Blvd Ste A
Goshen IN 46526-5858
Phone: (574) 875-5126
Fax: (574) 875-1874
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 06-005017-1 | Indiana |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 06-005017-1 | Indiana |
Profile Details
| NPI number | 1306863915 |
|---|---|
| LBN Legal business name | Beacon Medical Group, Inc. |
| DBA Doing business as | Beacon Medical Group Goshen |
| Authorized official | Costello, Jeffrey P |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Apr 24th, 2023 - about 3 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 | 1306863915 | NPPES |
| Indiana | Other | 000000110758 | ANTHEM BCBS |
| Indiana | MEDICAID | 200116290A | ANTHEM BCBS |
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