Organization
BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES, INC.
Active
Other names
Estill Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROLAND J GARDNER (CHIEF EXECUTIVE OFFICER)
(843) 987-7400
Entity
Organization
Contact information
Practice address
776 2ND ST E, ESTILL, SC 29918-4926
(803) 625-2548
(803) 625-2801
Mailing address
721 N OKATIE HWY # 170, RIDGELAND, SC 29936-8276
(843) 987-7400
(843) 987-7498
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
GP2554
SC
261QD0000X
Dental Clinic/Center
295441
SC
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
FQC101
SC
261QM2500X
Medical Specialty Clinic/Center
CBP005
SC
261QM2500X
Medical Specialty Clinic/Center
FQC101
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQC101
—
SC
Enumeration date
11/01/2012
Last updated
08/08/2016
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