Healthcare Provider Details

I. General information

NPI: 1386652741
Provider Name (Legal Business Name): BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 BALL PARK RD
ST. HELENA ISLAND SC
29920
US

IV. Provider business mailing address

PO BOX 1486
BEAUFORT SC
29901-1486
US

V. Phone/Fax

Practice location:
  • Phone: 843-838-2086
  • Fax:
Mailing address:
  • Phone: 843-524-4250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROLAND GARDNER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 843-987-7400