Healthcare Provider Details
I. General information
NPI: 1801203047
Provider Name (Legal Business Name): ROPER SAINT FRANCIS PHYSICIANS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/21/2014
Last Update Date: 03/17/2024
Certification Date: 03/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5070 INTERNATIONAL BLVD SUITE 131
NORTH CHARLESTON SC
29418
US
IV. Provider business mailing address
PO BOX 751649
CHARLOTTE NC
28275-1649
US
V. Phone/Fax
- Phone: 843-402-5053
- Fax: 843-724-1325
- Phone: 888-472-0043
- Fax: 843-724-2440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine 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