| Beacon Medical Group Ireland Road | |
|
1815 E Ireland Rd South Bend IN 46614-2845 | |
| (574) 647-1700 | |
| (574) 291-3351 |
| Full Name | Beacon Medical Group Ireland Road |
|---|---|
| Speciality | Family Medicine |
| Location | 1815 E Ireland Rd, South Bend, Indiana |
| Authorized Official Name and Position | Jeffrey Costello (VP-CFO) |
| Authorized Official Contact | 5746473549 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Medical Group Ireland Road 710 N Niles Ave South Bend IN 46617-1924 Ph: (574) 647-1610 | Beacon Medical Group Ireland Road 1815 E Ireland Rd South Bend IN 46614-2845 Ph: (574) 647-1700 |
| NPI Number | 1124079330 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 03/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124079330 | NPI | - | NPPES |
| 100224050B | Medicaid | IN |
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