Provider Demographics
NPI:1316381155
Name:BEACON MEDICAL, LLC
Entity Type:Organization
Organization Name:BEACON MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:814-943-1272
Mailing Address - Street 1:300 E WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-5210
Mailing Address - Country:US
Mailing Address - Phone:814-943-1272
Mailing Address - Fax:814-940-8516
Practice Address - Street 1:136 JAYCEE DR
Practice Address - Street 2:SUITE 10
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3650
Practice Address - Country:US
Practice Address - Phone:814-467-4055
Practice Address - Fax:814-262-8161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-23
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044867E207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty