Beacon Medical Group Pediatric Hematology Oncology

LBN: Beacon Medical Group, Inc.
Beacon Medical Group Pediatric Hematology Oncology is an health care organization with primary practice located at 615 N Michigan St 4Th Fl , South Bend IN 46601-1033. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 647-6892, or through Costello, Jeffrey via phone (574) 647-3549.

Contact Information

Primary practice address
615 N Michigan St 4Th Fl South Bend IN 46601-1033
Phone: (574) 647-6892
Fax: (574) 647-6895
Website:
Map and Directions
Authorized official contact:
Name: Costello, Jeffrey
Phone: (574) 647-3549

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X 02001713A Indiana

Profile Details

NPI number 1992756696
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group Pediatric Hematology Oncology
Authorized official Costello, Jeffrey
Entity Organization
Organization subpart 1 No
Enumeration date May 15th, 2006
Last updated Mar 4th, 2024 - about last year

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 1992756696 NPPES
Indiana MEDICAID 200510720A

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