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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