Basic Information
| Provider Information | |||||||||
| NPI: | 1831764927 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEAUFORT COUNTY MEMORIAL HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | BEAUFORT COUNTY MEMORIAL HOSPITAL | ||||||||
| Address2: | 955 RIBAUT RD | ||||||||
| City: | BEAUFORT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 299025441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435225790 | ||||||||
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| Practice Location | |||||||||
| Address1: | BEAUFORT MEMORIAL PULMONARY SPECIALIST | ||||||||
| Address2: | 122 OKATIE CENTER BLVD N STE 300 | ||||||||
| City: | OKATIE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 299093782 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435225775 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2021 | ||||||||
| LastUpdateDate: | 05/21/2021 | ||||||||
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| AuthorizedOfficialLastName: | SIMMONS | ||||||||
| AuthorizedOfficialFirstName: | TRIMMELL | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL STAFF COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 8435225790 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.