| Bhg Lxxx, Llc | |
|
2301 Cosgrove Ave Ste F Obot Room #100 North Charleston SC 29405-7663 | |
| (843) 529-0700 | |
| (843) 529-1681 |
| Full Name | Bhg Lxxx, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2301 Cosgrove Ave Ste F, North Charleston, South Carolina |
| Authorized Official Name and Position | Jay Higham (CEO) |
| Authorized Official Contact | 2143656112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bhg Lxxx, Llc 5001 Spring Valley Road Suite 600 East Dallas TX 75244-3946 Ph: (214) 365-6100 | Bhg Lxxx, Llc 2301 Cosgrove Ave Ste F Obot Room #100 North Charleston SC 29405-7663 Ph: (843) 529-0700 |
| NPI Number | 1659081644 |
|---|---|
| Provider Enumeration Date | 11/30/2022 |
| Last Update Date | 12/18/2024 |
| Certification Date | 12/18/2024 |
| Medicare PECOS PAC ID | 6608221684 |
|---|---|
| Medicare Enrollment ID | O20231011001431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659081644 | NPI | - | NPPES |
| Provider Name | Allen B Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902866965 PECOS PAC ID: 1759349376 Enrollment ID: I20050105000010 |
| Provider Name | Amanda B Salas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831128958 PECOS PAC ID: 1254389570 Enrollment ID: I20050217000557 |
| Provider Name | James J Harber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548219819 PECOS PAC ID: 1759316698 Enrollment ID: I20050929000634 |
| Provider Name | Brittany S Boyert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295334530 PECOS PAC ID: 9133534050 Enrollment ID: I20230816003040 |
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