| Beacon Medical Group Gastroenterology Elkhart | |
|
500 Arcade Ave Ste 300 Elkhart IN 46514-2486 | |
| (574) 389-7362 | |
| (574) 389-5612 |
| Full Name | Beacon Medical Group Gastroenterology Elkhart |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 500 Arcade Ave Ste 300, Elkhart, 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 Gastroenterology Elkhart 710 N Niles Ave South Bend IN 46617-1924 Ph: (574) 647-1610 | Beacon Medical Group Gastroenterology Elkhart 500 Arcade Ave Ste 300 Elkhart IN 46514-2486 Ph: (574) 389-7362 |
| NPI Number | 1699794057 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 10/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699794057 | NPI | - | NPPES |
| 300054801 | Medicaid | IN | |
| 300042826 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 06-005017-1 (Indiana) | Primary |
| 2085R0204X | Radiology - Vascular & Interventional Radiology | (* (Not Available)) | Secondary |
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Elkhart Clinic, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 303 S Nappanee St, Elkhart, IN 46514 Phone: 574-296-3200 Fax: 574-296-3392 | |
Elkhart Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2117 W Lexington Ave, Elkhart, IN 46514 Phone: 574-296-3444 Fax: 574-296-3328 | |
Elkhart Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2222 W Lexington Ave, Suite B, Elkhart, IN 46514 Phone: 574-296-3200 Fax: 574-296-3392 | |
Activate Healthcare - Waste Away Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1621 W Beardsley Ave, Elkhart, IN 46514 Phone: 773-697-3144 | |
Beacon Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1506 Osolo Rd Ste C, Elkhart, IN 46514 Phone: 574-266-6050 Fax: 574-262-8485 | |
Susan M Moore-riesbeck Do Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 28070 County Road 24, Elkhart, IN 46517 Phone: 574-273-8053 Fax: 574-273-8056 |