MEDICARE: ROPER ST. FRANCIS HOSPITAL - BERKELEY INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician

General Provider Information

NPI Number	:	1942058839
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROPER ST. FRANCIS HOSPITAL - BERKELEY INC

Provider Business Mailing Address
First Line	:	PO BOX 603957
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-3957
Country	:	US
Telephone Number	:	843-789-1726
Fax Number	:	843-402-5289

Provider Business Practice Location Address
First Line	:	300 CALLEN BLVD
Second Line	:
City	:	SUMMERVILLE
State	:	SC
Zip	:	29486-2815
Country	:	US
Telephone Number	:	854-529-3260
Fax Number	:	854-529-3261

Authorized Official
Title or Position	:	VP
Name	:	MATTHEW DESMOND
Credential	:
Telephone Number	:	843-724-2103

Provider Enumeration Date	:	05/07/2024
Last Update Date	:	05/07/2024

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