Beacon Medical Group Vascular Interventional Radiology
LBN: Beacon Medical Group, Inc.
Beacon Medical Group Vascular Interventional Radiology is an health care organization with primary practice located at 621 Memorial Dr Ste 312 , South Bend IN 46601-1073. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, which is considered as the primary health care specialty.
Beacon Medical Group, Inc. can be contacted via phone (574) 647-5200, or through Costello, Jeffrey P. via phone (574) 647-3549.
Contact Information
Primary practice address
621 Memorial Dr Ste 312
South Bend IN 46601-1073
Phone: (574) 647-5200
Fax: (574) 647-5210
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X |
Profile Details
| NPI number | 1932468352 |
|---|---|
| LBN Legal business name | Beacon Medical Group, Inc. |
| DBA Doing business as | Beacon Medical Group Vascular Interventional Radiology |
| Authorized official | Costello, Jeffrey P. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 4th, 2012 |
| Last updated | Oct 12th, 2017 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932468352 | NPPES |
| Indiana | MEDICAID | 201063130A |
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