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Organization
CONWAY HOSPITAL INC
Active
Organization
CONWAY HOSPITAL INC
Active
Other names
CMC PEDIATRICS CAROLINA FOREST, CMC PEDIATRICS TOWNE CENTER, CONWAY HOSPITAL COMMUNITY SERVICES, CPG PEDIATRICS CAROLINA FOREST
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
(843) 234-6946
Entity
Organization
Contact information
Practice address
4022 POSTAL WAY, SUITE C, MYRTLE BEACH, SC 29579-3537
(843) 903-4111
(843) 903-4242
Mailing address
300 SINGLETON RIDGE RD, ATTN: PATIENT ACCOUNTING, CONWAY, SC 29526-9142
(843) 234-6946
(843) 234-6990
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NULL
208000000X
Pediatrics Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4505
—
SC
Enumeration date
09/03/2008
Last updated
02/05/2021
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