Healthcare Provider Details

I. General information

NPI: 1134917735
Provider Name (Legal Business Name): THE BEACON HILL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 W ALAMEDA AVE STE 300
BURBANK CA
91505
US

IV. Provider business mailing address

4100 W ALAMEDA AVE STE 300
BURBANK CA
91505
US

V. Phone/Fax

Practice location:
  • Phone: 667-803-0636
  • Fax:
Mailing address:
  • Phone: 667-803-0636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KARRIEM MUHAMMAD
Title or Position: CEO
Credential:
Phone: 667-803-0636