Organization
CONWAY HOSPITAL, INC.
Active
Other names
CMC Primary Care Market Common
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
(843) 234-6946
Entity
Organization
Contact information
Practice address
1600 FARROW PARKWAY UNIT B3, MYRTLE BEACH, SC 29577-2011
(843) 839-4095
(843) 839-4096
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
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PG0275
—
SC
Enumeration date
01/08/2021
Last updated
03/07/2022
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