Healthcare Provider Details

I. General information

NPI: 1578607248
Provider Name (Legal Business Name): BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 OKATIE HWY # 170
OKATIE SC
29909-3963
US

IV. Provider business mailing address

PO BOX 357
RIDGELAND SC
29936-2605
US

V. Phone/Fax

Practice location:
  • Phone: 843-322-1873
  • Fax: 843-987-0023
Mailing address:
  • Phone: 843-322-1873
  • Fax: 843-987-0023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number760
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: FAITH LAWRENCE POLKEY
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 843-987-7400