Healthcare Provider Details

I. General information

NPI: 1871035956
Provider Name (Legal Business Name): BON SECOURS ST. FRANCIS XAVIER HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2016
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2095 HENRY TECKLENBURG DR
CHARLESTON SC
29414-5733
US

IV. Provider business mailing address

PO BOX 603484
CHARLOTTE NC
28260-3484
US

V. Phone/Fax

Practice location:
  • Phone: 843-402-1436
  • Fax: 843-402-1833
Mailing address:
  • Phone: 803-765-1838
  • Fax: 803-765-1732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: REBECCA TUCKER
Title or Position: SVP, CHIEF FINANCIAL OFFICER
Credential:
Phone: 843-203-2265