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Contact Information

BEACON MEDICAL GROUP, INC.
1020 HIGH RD
BREMEN, IN46506-1093
 Phone: 574-546-8044
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BEACON MEDICAL GROUP, INC.

NPI # 1558652347
LBN Legal business name BEACON MEDICAL GROUP, INC.
Authorized official JEFFREY COSTELLO - (VP/CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 04/27/2011
Last updated 08/30/2016 - About 10 years ago
Identifiers
IN License # 07001058A
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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