# CONWAY HOSPITAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CMC Student Health Coastal Carolina University
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366285207
- **Authorized official:** MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (843) 234-6946

## Contact information

- **Practice address:** 251 UNIVERSITY BLVD, STE B, CONWAY, SC 29526-8834
- **Practice address phone:** (843) 347-1012
- **Practice address fax:** (843) 347-1218
- **Mailing address:** 300 SINGLETON RIDGE RD, ATTENTION PNS CREDENTIALING, CONWAY, SC 29526-9142
- **Mailing address phone:** (843) 234-6946

## 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 | — | — | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | NULL | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/18/2024
- **Last updated:** 08/15/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | PG2281 | — | SC |