=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669726634
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2012
-----------------------------------------------------
Last Update Date | 03/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 211 PAIGE POINT RD
-----------------------------------------------------
City | SEABROOK
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29940-2737
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-846-8026
-----------------------------------------------------
Fax | 843-846-8312
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 721 N OKATIE HWY # 170
-----------------------------------------------------
City | RIDGELAND
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29936-8276
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-987-7400
-----------------------------------------------------
Fax | 843-987-7498
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF FINANCE OFFICER
-----------------------------------------------------
Name | MELISSA MAJOR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 843-987-7400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM2500X
-----------------------------------------------------
Taxonomy Name | Medical Specialty Clinic/Center
-----------------------------------------------------
License Number | FQC100
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number | 295441
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number | CBP005
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 261QC1500X
-----------------------------------------------------
Taxonomy Name | Community Health Clinic/Center
-----------------------------------------------------
License Number | GP2554
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 261QF0400X
-----------------------------------------------------
Taxonomy Name | Federally Qualified Health Center (FQHC)
-----------------------------------------------------
License Number | FQC100
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------