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Organization
ROPER HOSPITAL, INC.
Active
Organization
ROPER HOSPITAL, INC.
Active
Other names
The Ryan White Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REBECCA TUCKER (CFO)
(843) 203-2265
Entity
Organization
Contact information
Practice address
1481 TOBIAS GADSON BLVD, SUITE 1, CHARLESTON, SC 29407-4794
(843) 402-3093
(843) 402-3094
Mailing address
PO BOX 632500, CINCINNATI, OH 45263-2500
(888) 472-0043
(513) 653-4122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
SC
207RI0200X
Infectious Disease Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
083
BCBS SC AND BLUECHOICE SUFIX
SC
01
—
088/093
TRICARE SUFFIX
SC
05
—
GP5274
—
SC
Enumeration date
09/30/2009
Last updated
04/12/2026
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