Provider Demographics
NPI:1801121579
Name:BEACON HEALTH SYSTEM INC.
Entity type:Organization
Organization Name:BEACON HEALTH SYSTEM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:ORR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-522-5483
Mailing Address - Street 1:1665 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-8868
Mailing Address - Country:US
Mailing Address - Phone:740-522-5483
Mailing Address - Fax:
Practice Address - Street 1:1665 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-8868
Practice Address - Country:US
Practice Address - Phone:740-522-5483
Practice Address - Fax:740-522-5481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-13
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2609609Medicaid
OH2609609Medicaid