Beacon Medical Group-Elkhart East

LBN: Beacon Medical Group, Inc.
Beacon Medical Group-Elkhart East is an health care organization with primary practice located at 3301 County Road 6 E , Elkhart IN 46514-7673. 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) 264-9635, or through Costello, Jeffrey P via phone (574) 647-3549.

Contact Information

Primary practice address
3301 County Road 6 E Elkhart IN 46514-7673
Phone: (574) 264-9635
Fax: (574) 262-0398
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 06-0050171 Indiana

Profile Details

NPI number 1639196249
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group-Elkhart East
Authorized official Costello, Jeffrey P
Entity Organization
Organization subpart 1 No
Enumeration date Jul 17th, 2006
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 1639196249 NPPES
Indiana MEDICAID 100114000A
Indiana Other ANTHEM BCBS

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