Beacon Medical Group Wakarusa | |
207 N Elkhart St Wakarusa IN 46573-9729 | |
(574) 862-2165 | |
(574) 862-4112 |
Full Name | Beacon Medical Group Wakarusa |
---|---|
Speciality | Family Medicine |
Location | 207 N Elkhart St, Wakarusa, Indiana |
Authorized Official Name and Position | Jeffrey P Costello (CFO) |
Authorized Official Contact | 5746473549 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Beacon Medical Group Wakarusa 710 N Niles Ave South Bend IN 46617-1924 Ph: (574) 647-1610 | Beacon Medical Group Wakarusa 207 N Elkhart St Wakarusa IN 46573-9729 Ph: (574) 862-2165 |
NPI Number | 1184641706 |
---|---|
Provider Enumeration Date | 07/17/2006 |
Last Update Date | 03/04/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184641706 | NPI | - | NPPES |
ANTHEM BCBS | Other | IN | 000000110760 |
200019030A | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
News Archive
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Wanee Walk In Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1028 E Waterford St, Suite A, Wakarusa, IN 46573 Phone: 574-523-3227 Fax: 574-296-6522 | |
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