Organization
BEACON HEALTH VENTURES INC
Active
Other names
Beacon Home Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TRUDY KAY WAIT (PHARMACY MANAGER)
(574) 647-8674
Entity
Organization
Contact information
Practice address
3355 DOUGLAS RD, SOUTH BEND, IN 46635-1779
(574) 647-8675
(574) 647-8764
Mailing address
3355 DOUGLAS RD, SOUTH BEND, IN 46635-1779
(574) 647-8675
(574) 647-8764
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
12/16/2020
Last updated
01/11/2021
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