MEDICARE: ROPER SAINT FRANCIS PHYSICIANS NETWORK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	207Q00000X	Family Medicine Physician	SC
2	207R00000X	Internal Medicine Physician	SC
3	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417316704
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROPER SAINT FRANCIS PHYSICIANS NETWORK

Provider Business Mailing Address
First Line	:	PO BOX 751649
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1649
Country	:	US
Telephone Number	:	843-789-1620
Fax Number	:	843-724-2440

Provider Business Practice Location Address
First Line	:	5070 INTERNATIONAL BLVD
Second Line	:	SUITE 131
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29418-6006
Country	:	US
Telephone Number	:	843-763-7906
Fax Number	:	843-740-9039

Authorized Official
Title or Position	:	CEO RSFPP
Name	:	MR. DOUGLAS W BOWLING
Credential	:
Telephone Number	:	843-724-2480

Provider Enumeration Date	:	02/16/2016
Last Update Date	:	09/25/2017

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