Beacon Medical Group Obgyn River Oaks Lawn Aenue

LBN: Beacon Medical Group, Inc.
Beacon Medical Group Obgyn River Oaks Lawn Aenue is an health care organization with primary practice located at 1215 Lawn Ave Ste 100 , Elkhart IN 46514-2450. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 293-2893, or through Costello, Jeffrey P via phone (574) 647-3549.

Contact Information

Primary practice address
1215 Lawn Ave Ste 100 Elkhart IN 46514-2450
Phone: (574) 293-2893
Fax: (574) 293-1298
Website:
Map and Directions
Authorized official contact:
Name: Costello, Jeffrey P
Phone: (574) 647-3549

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 07-005017-1 Indiana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X

Profile Details

NPI number 1316073372
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group Obgyn River Oaks Lawn Aenue
Authorized official Costello, Jeffrey P
Entity Organization
Organization subpart 1 No
Enumeration date Feb 26th, 2007
Last updated Mar 4th, 2024 - about last year

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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1316073372 NPPES
Indiana MEDICAID 200853000A
Indiana Other 000000519823

Popular Providers