=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295534956
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROPER ST FRANCIS HOSPITAL-BERKELEY INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2025
-----------------------------------------------------
Last Update Date | 12/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 CALLEN BLVD
-----------------------------------------------------
City | SUMMERVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29486-2807
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 854-529-3100
-----------------------------------------------------
Fax | 843-529-3083
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 603964
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28260-3964
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-402-5200
-----------------------------------------------------
Fax | 843-402-5296
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF FINANCIAL OFFICER
-----------------------------------------------------
Name | REBECCA TUCKER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 843-203-2265
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------