Provider Demographics
NPI:1396125365
Name:BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-987-7400
Mailing Address - Street 1:PO BOX 357
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936-0357
Mailing Address - Country:US
Mailing Address - Phone:843-987-7400
Mailing Address - Fax:843-987-7484
Practice Address - Street 1:721 OKATIE HWY
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29909-3923
Practice Address - Country:US
Practice Address - Phone:843-987-7400
Practice Address - Fax:843-987-7484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty