NPIMap

Organization Active NPI

Beacon Health Ventures Inc

  • Home Infusion Agency
  • South Bend, IN
National Provider Identifier
1265028971
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
Legal business name
BEACON HEALTH VENTURES INC
Practice address
3355 Douglas Rd
South Bend, IN 46635-1779
Phone
(574) 647-8675
Fax
(574) 647-8764
NPI assigned
Dec 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Trudy Kay Wait
Title
Pharmacy Manager
Phone
(574) 647-8674

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

3355 Douglas Rd
South Bend, IN 46635-1779

Mailing address

3355 Douglas Rd
South Bend, IN 46635-1779
Phone (574) 647-8675

Other names 1

  • Beacon Home Care Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Memorial Home Care Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1265028971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 DOUGLAS RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351779",
            "telephone_number": "574-647-8675",
            "fax_number": "574-647-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 DOUGLAS RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351779",
            "telephone_number": "574-647-8675",
            "fax_number": "574-647-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON HEALTH VENTURES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-16",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "WAIT",
        "authorized_official_first_name": "TRUDY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "574-647-8674"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Home Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beacon Home Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.