Organization
ROPER HOSPITAL INC
Active
Other names
Roper Hospital ER Berkeley
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM ANTHONY JACKSON (CEO)
(843) 724-2954
Entity
Organization
Contact information
Practice address
730 STONY LANDING RD, MONCKS CORNER, SC 29461
(800) 846-7707
(843) 899-7885
Mailing address
PO BOX 601495, CHARLOTTE, NC 28260-1495
(843) 789-1620
(843) 724-2454
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5872
MEDICARE PTAN
SC
05
—
GP0574
—
SC
Enumeration date
01/02/2007
Last updated
11/27/2023
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