Organization
BEAUFORT JASPER HAMPTON COMPREHENSIVE HEALTH SERVICES, INC.
Active
Other names
Port Royal 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
1320 RIBAUT RD, PORT ROYAL, SC 29935-1118
(843) 986-0900
(843) 986-0566
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
FQC102
SC
261QM1300X
Multi-Specialty Clinic/Center
CBP005
SC
261QM2500X
Medical Specialty Clinic/Center
FQC102
SC
261QR0206X
Mammography Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQC102
—
SC
Enumeration date
10/30/2012
Last updated
08/09/2022
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