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Organization
BEAUFORT COUNTY MEMORIAL HOSPITAL
Active
Organization
BEAUFORT COUNTY MEMORIAL HOSPITAL
Active
Parent organization
BEAUFORT COUNTY MEMORIAL HOSPITAL
Other names
Beaufort Memorial LowCountry Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEAUFORT COUNTY MEMORIAL HOSPITAL
Authorized official
MR. EDMUND RUSSELL BAXLEY III (CEO)
(843) 522-5140
Entity
Organization
Contact information
Practice address
BEAUFORT MEMORIAL LOWCOUNTRY MEDICAL GROUP, 300 MIDTOWN, BEAUFORT, SC 29906-5200
(843) 770-0404
(844) 296-2308
Mailing address
955 RIBAUT RD, BMAC CREDENTIALING, BEAUFORT, SC 29902-5441
(843) 522-7843
(843) 522-5678
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101376
—
SC
05
—
270920
—
SC
01
—
3257
MEDICARE ID-TYPE UNSPECIFIED MEDICARE PART B
—
05
—
GP6561
—
SC
Enumeration date
06/10/2006
Last updated
07/09/2024
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