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Contact Information

BEACON MEDICAL GROUP, INC.
6913 N MAIN ST STE 300
GRANGER, IN46530
 Phone: 574-647-1500
 Fax: 574-647-2567
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Rheumatology

207RR0500X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for BEACON MEDICAL GROUP, INC.

NPI Number 1053361543
LBN Legal business name BEACON MEDICAL GROUP, INC.
Authorized official JEFFREY COSTELLO - (VP-CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/12/2006
Last updated 06/27/2018 - More than a year ago
Identifiers
IN License # 01043104A
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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