NPIMap

Organization Active NPI

Beacon Health Ventures Inc

Doing business as Beacon HC Pharmacy ELK

  • Home Infusion Therapy Pharmacy
  • Elkhart, IN
National Provider Identifier
1477816080
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
Legal business name
BEACON HEALTH VENTURES INC
Doing business as
Beacon HC Pharmacy ELK
Practice address
5155 Verdant St
Elkhart, IN 46516-9315
Phone
(574) 524-7582
Fax
(574) 524-7597
NPI assigned
Jun 19, 2012
Last updated
Feb 27, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Authorized official

Name
Gregory Conrad
Title
President
Phone
(574) 647-8777

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X
Durable Medical Equipment & Medical Supplies 332B00000X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Oxygen Equipment & Supplies (DME) 332BX2000X
Pharmacy 333600000X
Compounding Pharmacy 3336C0004X
Home Infusion Therapy Pharmacy 3336H0001X Primary

Addresses

Primary practice location

5155 Verdant St
Elkhart, IN 46516-9315

Mailing address

3355 Douglas Rd
Suite 100
South Bend, IN 46635-1781
Phone (574) 647-8731

Other identifiers 2

IdentifierTypeStateIssuer
2158807OtherPK
100301140CMedicaidIN

Other names 1

  • Beacon HC Pharmacy ELK Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1477816080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3355 DOUGLAS RD",
            "address_2": "SUITE 100",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351781",
            "telephone_number": "574-647-8731",
            "fax_number": "574-647-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5155 VERDANT ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169315",
            "telephone_number": "574-524-7582",
            "fax_number": "574-524-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON HEALTH VENTURES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-647-8777"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2158807",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100301140C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon HC Pharmacy ELK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.