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Contact Information

BEACON MEDICAL GROUP INC
1144 W PLYMOUTH ST
BREMEN, IN46506-1842
 Phone: 574-546-5363
 Fax: 574-546-2575
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Family

363LF0000X 50 Nurse Practitioner
 

Gynecology

207VG0400X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for BEACON MEDICAL GROUP INC

NPI # 1942781109
LBN Legal business name BEACON MEDICAL GROUP INC
Authorized official JEFFREY COSTELLO - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 08/27/2018
Last updated 02/22/2024 - About 2 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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