Provider Demographics
NPI:1801866728
Name:ROPER HOSPITAL INC
Entity Type:Organization
Organization Name:ROPER HOSPITAL INC
Other - Org Name:ROPER HOME INFUSION THERAPIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-720-8424
Mailing Address - Street 1:316 CALHOUN ST RM 2324
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1113
Mailing Address - Country:US
Mailing Address - Phone:843-720-8424
Mailing Address - Fax:843-720-8447
Practice Address - Street 1:316 CALHOUN ST RM 2324
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1113
Practice Address - Country:US
Practice Address - Phone:843-720-8424
Practice Address - Fax:843-720-8447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BP3500X, 3336C0004X
SC2830333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC728304Medicaid
2160985OtherPK
2160985OtherPK
0610290001Medicare ID - Type Unspecified
SCDME688Medicaid