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Contact Information

BEACON HEALTH VENTURES, INC
3355 DOUGLAS RD
SOUTH BEND, IN46635
 Phone: 574-647-2273
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Infusion Therapy Pharmacy

3336H0001X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for BEACON HEALTH VENTURES, INC

NPI Number 1699102046
LBN Legal business name BEACON HEALTH VENTURES, INC
Authorized official GREG CONRAD - (VICE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/01/2013
Last updated 06/17/2016 - About 10 years ago
Identifiers
IN License # 60004143A
IN Medicaid 100301140A
Other 000000097412 ANTHEM
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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