Beacon Medical Group Wanee

LBN: Beacon Medical Group, Inc.
Beacon Medical Group Wanee is an health care organization with primary practice located at 2102 N Main St , Nappanee IN 46550-9310. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 862-2165, or through Costello, Jeffrey P via phone (574) 647-3549.

Contact Information

Primary practice address
2102 N Main St Nappanee IN 46550-9310
Phone: (574) 862-2165
Fax: (574) 862-4112
Website:
Map and Directions
Authorized official contact:
Name: Costello, Jeffrey P
Phone: (574) 647-3549

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1457378069
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group Wanee
Authorized official Costello, Jeffrey P
Entity Organization
Organization subpart 1 No
Enumeration date Jul 17th, 2006
Last updated Apr 26th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457378069 NPPES
Indiana MEDICAID 300054202

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