Healthcare Provider Details
I. General information
NPI: 1659618627
Provider Name (Legal Business Name): ROPER SAINT FRANCIS PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/11/2013
Last Update Date: 11/27/2023
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2085 HENRY TECKLENBURG DR SUITE 320
CHARLESTON SC
29414
US
IV. Provider business mailing address
PO BOX 751649
CHARLOTTE NC
28275-1649
US
V. Phone/Fax
- Phone: 843-958-2606
- Fax: 843-606-7022
- Phone: 843-789-1620
- Fax: 843-724-2440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
R.
OLIVERIO
JR.
Title or Position: VP/CEO RSFPP
Credential:
Phone: 843-724-2903