Organization
BEACON MEDICAL GROUP, INC.
Active
Other names
Memorial Children's Hospital Navarre Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY COSTELLO (VP-CFO)
(574) 647-3549
Entity
Organization
Contact information
Practice address
100 NAVARRE PL STE 4440, SOUTH BEND, IN 46601-1171
(574) 647-4540
(574) 647-4542
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01046281A
IN
Other
Enumeration date
05/18/2006
Last updated
04/04/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up