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	261QC1500X	Community Health Clinic/Center	GP2554	SC
2	261QD0000X	Dental Clinic/Center	295441	SC
3	261QM1300X	Multi-Specialty Clinic/Center	CBP005	SC
4	261QM2500X	Medical Specialty Clinic/Center	FQC097	SC
5	261QF0400X	Federally Qualified Health Center (FQHC)	FQC097	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427302470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 357
Second Line	:
City	:	RIDGELAND
State	:	SC
Zip	:	29936-2605
Country	:	US
Telephone Number	:	843-987-7400
Fax Number	:	843-987-7498

Provider Business Practice Location Address
First Line	:	6315 JONATHAN FRANCIS SR. RD.
Second Line	:
City	:	ST. HELENA ISLAND
State	:	SC
Zip	:	29920-5401
Country	:	US
Telephone Number	:	843-838-2086
Fax Number	:	843-838-3906

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MRS. FAITH POLKEY
Credential	:
Telephone Number	:	843-987-7400

Provider Enumeration Date	:	10/30/2012
Last Update Date	:	07/01/2025

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