# CONWAY HOSPITAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CMC Primary Care Church Street
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073219325
- **Authorized official:** MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (843) 234-6946

## Contact information

- **Practice address:** 2701 CHURCH ST, STE A, CONWAY, SC 29526-4422
- **Practice address phone:** (843) 365-0295
- **Practice address fax:** (843) 365-0354
- **Mailing address:** 300 SINGLETON RIDGE RD, ATTENTION PNS CREDENTIALING, CONWAY, SC 29526-9142

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/07/2023
- **Last updated:** 09/15/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | PG2166 | — | SC |