Organization
MEMORIAL HOSPITAL OF SOUTH BEND
Active
Other names
Beacon Granger Hospital, A Memorial Hospital Extension
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY PETER COSTELLO (CFO)
(574) 647-3460
Entity
Organization
Contact information
Practice address
3220 BEACON PARKWAY, GRANGER, IN 46530
(574) 999-8788
(574) 999-8781
Mailing address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-1000
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300031565
—
IN
05
—
300032573
—
IN
Enumeration date
09/07/2018
Last updated
12/01/2022
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