Beacon Medical Group Specialists Plymouth

LBN: Beacon Medical Group, Inc.
Beacon Medical Group Specialists Plymouth is an health care organization with primary practice located at 2855 Miller Dr Suite 121, Plymouth IN 46563-8091. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Cardiovascular Disease is the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 647-1600, or through Costello, Jeffrey P via phone (574) 647-3549.

Contact Information

Primary practice address
2855 Miller Dr Suite 121 Plymouth IN 46563-8091
Phone: (574) 647-1600
Fax: (574) 237-6069
Website:
Map and Directions
Authorized official contact:
Name: Costello, Jeffrey P
Phone: (574) 647-3549

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 01045628A Indiana
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 01061323A Indiana

Profile Details

NPI number 1972831311
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group Specialists Plymouth
Authorized official Costello, Jeffrey P
Entity Organization
Organization subpart 1 No
Enumeration date Nov 23rd, 2009
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 1972831311 NPPES
Indiana MEDICAID 100092700C

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