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Organization
CONWAY HOSPITAL, INC.
Active
Organization
CONWAY HOSPITAL, INC.
Active
Other names
CMC Pediatrics Church Street
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
(843) 234-6946
Entity
Organization
Contact information
Practice address
2701 CHURCH ST, STE F, CONWAY, SC 29526-4422
(843) 369-0024
(843) 369-0072
Mailing address
300 SINGLETON RIDGE RD, ATTENTION PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NULL
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PG2221
—
SC
Enumeration date
05/17/2024
Last updated
07/02/2024
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