Covered Entity Details

CH04119AB BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED (Approved) - information as of 4/29/2025 1:41:01 AM

Main Details

Name

BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED

Subdivision Name

Varnville Medical Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-039764

340B ID

CH04119AB

Grant Number

H80CS00699

Additional Details

Current Program Status

Approved

Registration Date

4/15/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/24/2025

Last Recertification Date

Contacts

Authorizing Official

BJHCHS, Inc
Faith L Polkey, CEO
(843) 987-7448

Primary Contact

BJHCHS, Inc.
Courtney Kaye, Director of Pharmacy
(843) 987-7454

Addresses

Street Address

1000 W Pine St
Varnville, SC 29944

Billing Address

Beaufort Jasper Hampton Comprehensive Health Services, Inc.
PO BOX 357
Ridgeland, SC 29936

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
SC		1073318259

Shipping Addresses

Shipping Address 1

Varnville Medical Center
1000 W Pine St
Varnville, SC 29944

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH041190	Active	BPS-H80-001803	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	RUTH P. FIELD MEDICAL CENTER	719 N Okatie Hwy	Ridgeland	SC
CH04119A	Active	BPS-H80-001163	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	ELIJAH WASHINGTON MEDICAL CENTER	211 PAIGE POINT RD	SEABROOK	SC
CH04119AA	Approved	BPS-H80-002644	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	BEAUFORT-JASPER HAMPTON COMP HLTH SERVICES, INC.	721 Okatie Hwy	Okatie	SC
CH04119AB	Approved	BPS-H80-039764	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	Varnville Medical Center	1000 W Pine St	Varnville	SC
CH04119B	Active	BPS-H80-000226	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	DONALD E. GATCH MEDICAL CENTER	552 Stiney Rd	Hardeeville	SC
CH04119C	Active	BPS-H80-009246	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	Leroy E. Browne Medical Center	6315 Jonathan Francis Sr Rd	Saint Helena Island	SC
CH04119D	Active	BPS-H80-001677	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	RIDGELAND MEDICAL CENTER	1520 Grays HIGHWAY	RIDGELAND	SC
CH04119E	Active	BPS-H80-003203	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	PORT ROYAL MEDICAL CENTER	1320 Ribaut Rd	Port Royal	SC
CH04119J	Active	BPS-H80-005528	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	HAMPTON MEDICAL CENTER	200 Elm St E	Hampton	SC
CH04119L	Active	BPS-H80-001382	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	ESTILL MEDICAL CENTER	777 East Second Street	Estill	SC
CH04119M	Active	BPS-H80-017991	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	Port Royal Medical Center II	2210-B Mossy Oaks Rd	Port Royal	SC
CH04119N	Active	BPS-H80-033411	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	Port Royal OB/GYN	1264 Ribaut Rd Ste 200	Beaufort	SC
CH04119P	Active	BPS-H80-014501	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	BJHCHS Mobile Unit	200 Elm St E	Hampton	SC
CH04119Q	Active	BPS-H80-002431	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	JAMES J DAVIS EARLY LEARNING CENTER	364 KEAN NECK RD	DALE	SC
CH04119R	Active	BPS-H80-010353	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	Whale Branch Early College High School	69 Detour Rd	Seabrook	SC
CH04119S	Active	BPS-H80-010169	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	Whale Branch Elementary School	15 Stuart Point Rd	Seabrook	SC
CH04119T	Active	BPS-H80-033581	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	St. Helena Elementary School	1025 Sea Island Pkwy	St Helena Is	SC
CH04119U	Active	BPS-H80-003587	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	WHALE BRANCH MIDDLE SCHOOL	2009 Trask Pkwy	Seabrook	SC
CH04119V	Active	BPS-H80-005025	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	BROAD RIVER ELEM SCHOOL HLTH CTR	474 BROAD RIVER BLVD HWY 20	BURTON	SC
CH04119W	Active	BPS-H80-001982	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	HARDEEVILLE RIDGELAND MIDDLE SCHOOL	150 Hurricane Alley	HARDEEVILLE	SC
CH04119X	Active	BPS-H80-032238	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	Beaufort Jasper Hampton Comprehensive Health Services Mobile Unit	719 Okatie Hwy	Okatie	SC
CH04119Y	Active	BPS-H80-004860	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	RIDGELAND HARDEEVILLE HIGH SCHOOL	250 Jaguar Trl	Ridgeland	SC
CH04119Z	Active	BPS-H80-030222	BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	BJHCHS Ronald McDonald Mobile Unit	719 Okatie Hwy	Okatie	SC

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH041190	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	04/01/2024	03/18/2025
CH041190	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	04/01/2024
CH041190	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	04/01/2024	03/18/2025
CH041190	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	04/01/2024	03/18/2025
CH041190	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	04/01/2024	03/18/2025
CH041190	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	04/01/2024
CH041190	AVITA PHARMACY 1037	AVITA DRUGS LLC-NOLA D/B/A AVITA PHARMAC	2519 CANAL ST	NEW ORLEANS	LA	70119	10/01/2017	07/10/2023
CH041190	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	10/01/2017	01/31/2025
CH041190	BEAUFORT PHARMACY, LLC	D/B/A BEAUFORT PHARMACY & COMPOUNDING	968 RIBAUT RD STE 1	BEAUFORT	SC	29902-8003	10/01/2017	06/29/2020
CH041190	BI-LO PHARMACY #5158	2127 BOUNDARY STREET	SUITE 19	BEAUFORT	SC	29902	10/01/2017	06/02/2020
CH041190	BI-LO PHARMACY #5525	860 PARIS ISLAND GATEWAY	SUITE N	BEAUFORT	SC	29906	10/01/2017	06/02/2020
CH041190	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	01/01/2024
CH041190	CAROLINA PHARMACY OF THE LOWCOUNTRY	810 ELM STREET EAST		HAMPTON	SC	29924-2610	10/01/2017	06/29/2020
CH041190	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	01/01/2024
CH041190	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	01/01/2024
CH041190	FREDS PHARMACY #3171	181 WEST CAROLINA AVENUE	P.O. BOX 1326	VARNVILLE	SC	29944	07/01/2017	10/07/2019
CH041190	GEORGIA CVS PHARMACY, L.L.C.	CVS PHARMACY # 17397	1907 E VICTORY DR	SAVANNAH	GA	31404	10/01/2019	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06369	5690 OGEECHEE RD.	SAVANNAH	GA	31405	10/01/2019	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04261	2055 EAST VICTORY DR	SAVANNAH	GA	31404	10/01/2019	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04230	150 JOHNNY MERCER BLVD	SAVANNAH	GA	31410	10/01/2019	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 00060	7300 GA HIGHWAY 21	PORT WENTWORTH	GA	31407	01/01/2020	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03979	4717-C E HWY 80	SAVANNAH	GA	31410	01/01/2020	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04187	119 BULL ST	SAVANNAH	GA	31401	01/01/2020	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04257	712 STEPHENSON AVE.	SAVANNAH	GA	31405	01/01/2020	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04258	100 MINUS AVE.	GARDEN CITY	GA	31408	01/01/2020	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04260	4725 WATERS AVE	SAVANNAH	GA	31404	01/01/2020	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05520	5401 ABERCORN STREET	SAVANNAH	GA	31405	01/01/2020	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07758	410 S. COLUMBIA AVE.	RINCON	GA	31326	01/01/2020	03/21/2022
CH041190	GEORGIA CVS PHARMACY, L.L.C.	CVS/PHARMACY # 11017	500 POOLER PKWY.	POOLER	GA	31322	01/01/2020	03/21/2022
CH041190	ICARE RX LLC	14447 COUNTRY WALK DR		MIAMI	FL	33186	10/01/2024
CH041190	KROGER DRUG STORE #499	125 TOWNE DRIVE		BLUFFTON	SC	29910	10/01/2019	01/14/2024
CH041190	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	10/01/2017	01/31/2025
CH041190	LONGS DRUGS OF RIDGELAND, SC, INC	D/B/A MAIN STREET PHARMACY	7752 WEST MAIN STREET P.O. BOX 2188	RIDGELAND	SC	29936	10/01/2019	01/31/2023
CH041190	MEDEXPRESS PHARMACY LTD		1431 W INNES STREET	SALISBURY	NC	28144	10/01/2017	01/31/2025
CH041190	PHYSICIAN'S RX PHARMACY, LLC	PHYSICIANS RX PHARMACY, LLC	9701 APOLLO DRIVE #400	LARGO	MD	20774	10/01/2024
CH041190	PRXP OF CA LLC	PRXP OF CA LLC	4345 E LOWELL ST STE C & D	ONTARIO	CA	91761	10/01/2024
CH041190	PRXP OF NEW YORK LLC	DBA BROADWAY FAMILY PHARMACY	601 AMSTERDAM AVE	NEW YORK	NY	10024	10/01/2024
CH041190	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04489	1006 FORDING ISLAND ROAD	BLUFFTON	SC	29910	10/01/2019
CH041190	SOUTH CAROLINA CVS PHARMACY, L.L.C.	CVS PHARMACY # 16641	1050 FORDING ISLAND RD	BLUFFTON	SC	29910	10/01/2019
CH041190	SOUTH CAROLINA CVS PHARMACY, L.L.C.	CVS/PHARMACY # 11255	40 D. MARK CUMMINGS RD.	HARDEEVILLE	SC	29927	10/01/2019
CH041190	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05566	10 POPE AVENUE	HILTON HEAD ISLAND	SC	29928	10/01/2019
CH041190	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03826	1500 RIBAUT ROAD	PORT ROYAL	SC	29935	10/01/2019
CH041190	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03861	705 ELM ST. WEST	HAMPTON	SC	29924	10/01/2019
CH041190	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07333	85 MATHEWS DR	HILTON HEAD ISLAND	SC	29926	01/01/2020
CH041190	SOUTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03585	555 ROBERTSON BLVD.	WALTERBORO	SC	29488	07/01/2022
CH041190	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2017
CH041190	WAL-MART PHARMACY 10-1383	350 ROBERT SMALLS PARKWAY		BEAUFORT	SC	29906	07/01/2017
CH041190	WAL-MART PHARMACY 10-2832	4400 HIGHWAY 278		HARDEEVILLE	SC	29927	07/01/2017
CH041190	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2017
CH041190	WALGREEN CO	DBA: WALGREENS #11252	2363 BOUNDARY ST	BEAUFORT	SC	29902-3735	10/01/2017
CH041190	WALGREEN CO	DBA: WALGREENS #09134	138 OKATIE CENTER BLVD S	OKATIE	SC	29909	10/01/2017
CH041190	WALGREEN CO.	DBA: WALGREENS # 06597	155 SEA ISLAND PARKWAY	BEAUFORT	SC	29907-1560	10/01/2017
CH041190	WALGREEN CO.	WALGREENS #16396	805 PAMPLICO HWY. SUITE B-130	FLORENCE	SC	29505	10/01/2017	02/10/2022
CH041190	WALGREEN CO.	RITE AID #11674	136 SEA ISLAND PKWY STE B	BEAUFORT	SC	29907	07/01/2018	12/01/2018
CH041190	WALGREEN CO.	WALGREENS #18050	1294 RIBAUT RD	BEAUFORT	SC	29902	07/01/2018
CH041190	WALGREEN CO.	WALGREENS #17239	8225 E MAIN ST STE F	RIDGELAND	SC	29936	10/01/2018
CH041190	WALGREEN CO.	DBA: WALGREENS # 04980	20 HATTON PL STE 100	HILTON HEAD ISLAND	SC	29926-4205	10/01/2019	02/10/2022
CH041190	Walgreens #21420	Walgreens Central Fill #21420	8440 Times Dispatch Blvd Ste. 400	Mechanicsville	VA	23116	10/01/2023
CH041190	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH041190	WALMART PHARMACY 10-6395	4 BLUFFTON RD		BLUFFTON	SC	29910	10/01/2019	06/01/2023
CH041190	WALMART PHARMACY 10-7181	265 SEA ISLAND PARKWAY		BEAUFORT	SC	29907	04/01/2022
CH041190	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH04119L	WELVISTA INC	WELVISTA	121 GREYSTONE BLVD	COLUMBIA	SC	29210	07/02/2010	06/05/2017
CH04119J	WELVISTA INC	WELVISTA	121 GREYSTONE BLVD	COLUMBIA	SC	29210	07/02/2010	06/05/2017

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		Polkey, Faith L CEO BJHCHS, Inc 8439877448	4/24/2025 7:23 AM
Details	340B ID	Update	New Registration		CH04119AB	4/24/2025 7:23 AM
Dates	Participating Approval Date	Update	New Registration		4/24/2025 7:23:58 AM	4/24/2025 7:23 AM
Details	State	Update	New Registration	Pending	Approved	4/24/2025 7:23 AM
Dates	Signed By Date	Update	New Registration		4/15/2025 10:30:01 PM	4/24/2025 7:23 AM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/24/2025 7:23 AM
Addresses	Main Address	Insert	New Registration		1000 W Pine St Varnville, SC 29944	4/15/2025 9:59 PM
Addresses	Billing Address	Insert	New Registration		Beaufort Jasper Hampton Comprehensive Health Services, Inc. PO BOX 357 Ridgeland, SC 29936	4/15/2025 9:59 PM
Addresses	Shipping Address	Insert	New Registration		Varnville Medical Center 1000 W Pine St Varnville, SC 29944	4/15/2025 9:59 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1073318259	4/15/2025 9:59 PM
Medicaid Billing	NPI: State	Insert	New Registration		SC	4/15/2025 9:59 PM
Contacts	Authorizing Official	Insert	New Registration		Polkey, Faith L CEO BJHCHS, Inc 8439877448	4/15/2025 9:59 PM
Contacts	Primary Contact	Insert	New Registration		Kaye, Courtney Director of Pharmacy BJHCHS, Inc. 8439877454	4/15/2025 9:59 PM
Details	Assistance Received From Date	Insert	New Registration			4/15/2025 9:59 PM
Details	Assistance Received To Date	Insert	New Registration			4/15/2025 9:59 PM
Details	Last Recertification Date	Insert	New Registration			4/15/2025 9:59 PM
Details	Grant Number	Insert	New Registration		H80CS00699	4/15/2025 9:59 PM
Details	340B ID	Insert	New Registration			4/15/2025 9:59 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/15/2025 9:59 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/15/2025 9:59 PM
Details	Medicare Provider Number	Insert	New Registration			4/15/2025 9:59 PM
Details	Entity Name	Insert	New Registration		BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED	4/15/2025 9:59 PM
Details	NOFO Number	Insert	New Registration			4/15/2025 9:59 PM
Details	Program Code	Insert	New Registration		CH	4/15/2025 9:59 PM
Details	Entity Subname	Insert	New Registration		Varnville Medical Center	4/15/2025 9:59 PM
Dates	Participating Approval Date	Insert	New Registration			4/15/2025 9:59 PM
Details	State	Insert	New Registration		Pending	4/15/2025 9:59 PM
Dates	Registration Date	Insert	New Registration		4/15/2025 9:59:10 PM	4/15/2025 9:59 PM
Dates	Signed By Date	Insert	New Registration			4/15/2025 9:59 PM
Dates	Start Date	Insert	New Registration			4/15/2025 9:59 PM
Terminations	Termination Comments	Insert	New Registration			4/15/2025 9:59 PM
Terminations	Termination Date	Insert	New Registration			4/15/2025 9:59 PM
Terminations	Termination Effective Date	Insert	New Registration			4/15/2025 9:59 PM
Terminations	Termination Reason	Insert	New Registration			4/15/2025 9:59 PM

340B Drug Pricing Program Database