# CONWAY HOSPITAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CMC Pediatrics Conway, CONWAY HOSPITAL COMMUNITY SERVICES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558835355
- **Authorized official:** MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (843) 234-6946

## Contact information

- **Practice address:** 124 PROFESSIONAL PARK DRIVE, STE A, CONWAY, SC 29526-9260
- **Practice address phone:** (843) 234-8788
- **Practice address fax:** (843) 234-8787
- **Mailing address:** 300 SINGLETON RIDGE RD, ATTN: PATIENT ACCOUNTING, CONWAY, SC 29526-9142
- **Mailing address phone:** (843) 234-6946
- **Mailing address fax:** (843) 234-6990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/15/2019
- **Last updated:** 07/13/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP8821 | — | SC |