=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336603646
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROPER ST FRANCIS HOSPITAL-BERKELEY INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2019
-----------------------------------------------------
Last Update Date | 11/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 CALLEN BLVD
-----------------------------------------------------
City | SUMMERVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29486-2807
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 854-529-3100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8536 PALMETTO COMMERCE PKWY STE 205 REIMBURSEMENT
-----------------------------------------------------
City | LADSON
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29456-6700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-789-1726
-----------------------------------------------------
Fax | 843-402-5289
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | REBECCA TUCKER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 843-727-3403
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------