Healthcare Provider Details

I. General information

NPI: 1740802297
Provider Name (Legal Business Name): ROPER HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2020
Last Update Date: 11/27/2023
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 N HIGHWAY 17
MT PLEASANT SC
29466-9123
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-724-2289
  • Fax: 843-606-8038
Mailing address:
  • Phone: 843-789-1620
  • Fax: 843-724-2454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM JACKSON
Title or Position: CEO
Credential:
Phone: 843-724-2952