Provider Demographics
NPI: | 1164214755 |
---|---|
Name: | ROPER ST FRANCIS HOSPITAL-BERKELEY INC. |
Entity type: | Organization |
Organization Name: | ROPER ST FRANCIS HOSPITAL-BERKELEY INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | REBECCA |
Authorized Official - Middle Name: | ANN |
Authorized Official - Last Name: | TUCKER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 843-727-3403 |
Mailing Address - Street 1: | PO BOX 603964 |
Mailing Address - Street 2: | |
Mailing Address - City: | CHARLOTTE |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28260-3964 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 843-789-1726 |
Mailing Address - Fax: | 843-402-5289 |
Practice Address - Street 1: | 200 CALLEN BLVD STE 110 |
Practice Address - Street 2: | |
Practice Address - City: | SUMMERVILLE |
Practice Address - State: | SC |
Practice Address - Zip Code: | 29486-2808 |
Practice Address - Country: | US |
Practice Address - Phone: | 843-724-2289 |
Practice Address - Fax: | 843-606-8038 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-05-20 |
Last Update Date: | 2025-06-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | Group - Multi-Specialty |