Provider Demographics
NPI:1679120828
Name:ROPER ST FRANCIS HOSPITAL-BERKELEY INC.
Entity Type:Organization
Organization Name:ROPER ST FRANCIS HOSPITAL-BERKELEY INC.
Other - Org Name:BERKELEY HOSPITAL ER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:BRET
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-724-2946
Mailing Address - Street 1:PO BOX 603957
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3957
Mailing Address - Country:US
Mailing Address - Phone:843-789-1726
Mailing Address - Fax:843-402-5289
Practice Address - Street 1:100 CALLEN BLVD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-2807
Practice Address - Country:US
Practice Address - Phone:854-529-3165
Practice Address - Fax:854-529-3057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-22
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP9485Medicaid