Provider Demographics
NPI:1033652730
Name:ROPER ST. FRANCIS EXPRESS CARE
Entity Type:Organization
Organization Name:ROPER ST. FRANCIS EXPRESS CARE
Other - Org Name:ROPER ST. FRANCIS PHYSICIANS PARTNERS
Other - Org Type:Other Name
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:HARPER
Authorized Official - Last Name:MCNEIL
Authorized Official - Suffix:
Authorized Official - Credentials:NP-FNP
Authorized Official - Phone:843-763-7906
Mailing Address - Street 1:5070 INTERNATIONAL BLVD STE 131
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-6007
Mailing Address - Country:US
Mailing Address - Phone:843-163-7906
Mailing Address - Fax:
Practice Address - Street 1:5070 INTERNATIONAL BLVD STE 131
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29418-6007
Practice Address - Country:US
Practice Address - Phone:843-763-7906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20489305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service