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Organization

BEACON MEDICAL GROUP, INC.

Active
Parent organization
BEACON HEALTH SYSTEM, INC.
Other names
Beacon Medical Group- Buchanan
Organization subpart
Yes

Provider details

NPI number
Legal business name
BEACON HEALTH SYSTEM, INC.
Authorized official
MR. JEFFREY P. COSTELLO (CFO)
(574) 647-3549
Entity
Organization

Contact information

Practice address
804 E FRONT ST, BUCHANAN, MI 49107-1444
(269) 695-3897
(269) 695-6407
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
06/23/2015
Last updated
09/20/2016
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