Beacon Medical Group Midwifery Centered Care South Bend

LBN: Beacon Medical Group, Inc.
Beacon Medical Group Midwifery Centered Care South Bend is an health care organization with primary practice located at 621 Memorial Dr Ste 403 , South Bend IN 46601-1074. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 647-1405, or through Costello, Jeffrey P via phone (574) 647-3549.

Contact Information

Primary practice address
621 Memorial Dr Ste 403 South Bend IN 46601-1074
Phone: (574) 647-1405
Fax: (574) 647-3970
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
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 72000053A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X

Profile Details

NPI number 1578862181
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group Midwifery Centered Care South Bend
Authorized official Costello, Jeffrey P
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 22nd, 2011
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578862181 NPPES
Indiana MEDICAID 201020740A

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