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BEACON MEDICAL GROUP INC. NPI 1780856724


NPI Information

NPI: 1780856724
Provider Name: BEACON MEDICAL GROUP, INC.

Doing Business As: BEACON MEDICAL GROUP OCCUPATIONAL HEALTH SOUTH BEND

Classification: Preventive Medicine - 2083A0100X
Entity Type: Organization

Specialization: Aerospace Medicine

Address:
2301 N BENDIX DR
SUITE 500
SOUTH BEND, IN
ZIP 46628
Phone: (574) 647-1675
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BEACON MEDICAL GROUP, INC. is an aerospace medicine preventive medicine in South Bend, IN. The provider is aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures. BEACON MEDICAL GROUP, INC. NPI is 1780856724. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Beacon Medical Group Occupational Health South Bend.

The provider's business location address is:

2301 N BENDIX DR
SUITE 500
SOUTH BEND, IN
ZIP 46628-486
Phone: (574) 647-1675
Fax: (574) 232-5595

The provider's authorized official is Jeffrey P. Costello .
The authorized official title is Vp/cfo and has the following contact phone number (574) 647-3549.

The enumeration date for this NPI number is 3/31/2008 and was last updated on 8/30/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamily71000502AINDIANANo
22083A0100XPreventive MedicineAerospace Medicine01047560AINDIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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