MEDICARE: BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

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

Provider Business Mailing Address
First Line	:	PO BOX 1486
Second Line	:
City	:	BEAUFORT
State	:	SC
Zip	:	29901-1486
Country	:	US
Telephone Number	:	843-524-4250
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 BALL PARK RD
Second Line	:
City	:	ST. HELENA ISLAND
State	:	SC
Zip	:	29920
Country	:	US
Telephone Number	:	843-838-2086
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ROLAND GARDNER
Credential	:
Telephone Number	:	843-987-7400

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	08/22/2020

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