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
1	207V00000X	Obstetrics & Gynecology Physician
2	261QF0050X	Non-Surgical Family Planning Clinic/Center
3	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1457005431
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	:

Provider Business Practice Location Address
First Line	:	1264 RIBAUT RD STE 200
Second Line	:
City	:	BEAUFORT
State	:	SC
Zip	:	29902-6127
Country	:	US
Telephone Number	:	843-987-7400
Fax Number	:

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

Provider Enumeration Date	:	02/08/2022
Last Update Date	:	02/15/2022

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