Provider Demographics
NPI:1144364845
Name:BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICE INC
Entity type:Organization
Organization Name:BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:POLKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
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:29936-2605
Mailing Address - Country:US
Mailing Address - Phone:843-322-1871
Mailing Address - Fax:843-466-0849
Practice Address - Street 1:211 PAIGE POINT RD
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:SC
Practice Address - Zip Code:29940-2737
Practice Address - Country:US
Practice Address - Phone:843-322-1871
Practice Address - Fax:843-466-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
SC15233336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC715233Medicaid
2088977OtherPK
421908Medicare PIN