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Organization
CONWAY HOSPITAL COMMUNITY SERVICES
Active
Organization
CONWAY HOSPITAL COMMUNITY SERVICES
Active
Other names
CPG Center for Wound Healing
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRET A BARR (CFO)
(843) 347-7111
Entity
Organization
Contact information
Practice address
300 SINGLETON RIDGE RD, CONWAY, SC 29526-9142
(843) 347-8347
(843) 234-6977
Mailing address
PO BOX 2180, CONWAY, SC 29528-2180
(843) 234-5139
(843) 234-6822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7844
MEDICARE PTAN
SC
01
—
DC2203
RAILROAD MEDICARE GROUP
SC
05
—
GP4505
—
SC
Enumeration date
11/06/2012
Last updated
05/10/2016
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