BEACON MEDICAL GROUP, INC.; NPI #1487061131

Contact Information

BEACON MEDICAL GROUP, INC.

2400 N VENTURA WAY
LAGRANGE, IN 46761-4101

Phone: 574-524-7123
Fax: 574-296-6522
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Cardiovascular Disease	207RC0000X	11	Physician/Internal Medicine

Indicates primary specialty

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NPI Profile & details for BEACON MEDICAL GROUP, INC.

NPI #	`1487061131`
LBN Legal business name	BEACON MEDICAL GROUP, INC.
Authorized official	JEFFREY COSTELLO - (CFO)
Entity	Organization
Organization subpart ¹	No
Enumeration date	07/15/2014
Last updated	08/30/2016 - About 10 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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