Healthcare Provider Details

I. General information

NPI: 1619947140
Provider Name (Legal Business Name): ROPER ST FRANCIS ANCILLARY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8536 PALMETTO COMMERCE PKWY STE 207A
LADSON SC
29456-6700
US

IV. Provider business mailing address

8536 PALMETTO COMMERCE PKWY STE 207A
LADSON SC
29456-6700
US

V. Phone/Fax

Practice location:
  • Phone: 843-402-7000
  • Fax: 843-769-6205
Mailing address:
  • Phone: 843-402-7000
  • Fax: 843-769-6205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA-062
License Number StateSC

VIII. Authorized Official

Name: KIMBERLY M RALSTON
Title or Position: SYSTEM DIRECTOR
Credential:
Phone: 419-996-5119