MEDICARE: SUMMIT BHC CAMERON, LLC

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	324500000X	Substance Abuse Rehabilitation Facility		SC

General Provider Information

NPI Number	:	1457800310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT BHC CAMERON, LLC

Provider Business Mailing Address
First Line	:	5401 NETHERBY LN STE 402
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-7363
Country	:	US
Telephone Number	:	854-444-5200
Fax Number	:	854-444-5210

Provider Business Practice Location Address
First Line	:	5401 NETHERBY LN STE 402
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-7363
Country	:	US
Telephone Number	:	854-444-5200
Fax Number	:	854-444-5210

Authorized Official
Title or Position	:	GENERAL COUNSEL & SECRETARY
Name	:	JAMES STEPHEN HINKLE
Credential	:
Telephone Number	:	615-637-7218

Provider Enumeration Date	:	10/03/2016
Last Update Date	:	06/19/2026

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