Memorial Pain Management

LBN: Beacon Medical Group, Inc.
Memorial Pain Management is an health care organization with primary practice located at 621 Memorial Dr Suite 602, South Bend IN 46601-1063. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 647-7413, or through Costello, Jeffrey P. via phone (574) 647-3549.

Contact Information

Primary practice address
621 Memorial Dr Suite 602 South Bend IN 46601-1063
Phone: (574) 647-7413
Fax: (574) 647-2471
Website:
Map and Directions
Authorized official contact:
Name: Costello, Jeffrey P.
Phone: (574) 647-3549

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 71001587A Indiana

Profile Details

NPI number 1518302264
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Memorial Pain Management
Authorized official Costello, Jeffrey P.
Entity Organization
Organization subpart 1 No
Enumeration date May 8th, 2013
Last updated Aug 30th, 2016 - about 9 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 1518302264 NPPES
Indiana MEDICAID 201164630A

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