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Organization
CONWAY HOSPITAL, INC.
Active
Organization
CONWAY HOSPITAL, INC.
Active
Other names
CMC Primary Care Surfside Beach
Organization subpart
No
Provider details
NPI number
Authorized official
BRET BARR (CEO)
(843) 347-8114
Entity
Organization
Contact information
Practice address
1413 HIGHWAY 17 N, SURFSIDE BEACH, SC 29575-6012
(843) 238-5654
(843) 238-1624
Mailing address
300 SINGLETON RIDGE RD, ATTENTION PATIENT ACCOUNTING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP8566
—
SC
Enumeration date
03/08/2018
Last updated
10/25/2021
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