Healthcare Provider Details

I. General information

NPI: 1164214755
Provider Name (Legal Business Name): ROPER ST FRANCIS HOSPITAL-BERKELEY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CALLEN BLVD STE 110
SUMMERVILLE SC
29486-2808
US

IV. Provider business mailing address

PO BOX 603964
CHARLOTTE NC
28260-3964
US

V. Phone/Fax

Practice location:
  • Phone: 843-724-2289
  • Fax: 843-606-8038
Mailing address:
  • Phone: 843-789-1726
  • Fax: 843-402-5289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: REBECCA ANN TUCKER
Title or Position: CFO
Credential:
Phone: 843-203-2265