Healthcare Provider Details

I. General information

NPI: 1013959816
Provider Name (Legal Business Name): ROPER HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 HENRY TECKLENBURG DR SUITE 120
CHARLESTON SC
29414-5893
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-789-1633
  • Fax: 843-724-2454
Mailing address:
  • Phone: 843-789-1633
  • Fax: 843-724-2454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. BRET JOHNSON
Title or Position: CFO
Credential:
Phone: 843-724-2946