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Organization
CONWAY HOSPITAL, INC.
Active
Organization
CONWAY HOSPITAL, INC.
Active
Other names
CMC Primary Care Towne Center, CMC Quick Care Postal Way, CPG FAMILY MEDICINE AT TOWNE CENTRE
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
(843) 234-6946
Entity
Organization
Contact information
Practice address
5010 CAROLINA FOREST BLVD, MYRTLE BEACH, SC 29579-3579
(843) 236-2700
(843) 236-2726
Mailing address
300 SINGLETON RIDGE ROAD, ATTENTION PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946
(843) 234-6990
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4505
—
SC
Enumeration date
03/17/2009
Last updated
08/23/2024
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