Organization
CONWAY HOSPITAL, INC.
Active
Other names
CMC Pediatrics Conway, CONWAY HOSPITAL COMMUNITY SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
(843) 234-6946
Entity
Organization
Contact information
Practice address
124 PROFESSIONAL PARK DRIVE, STE A, CONWAY, SC 29526-9260
(843) 234-8788
(843) 234-8787
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
—
—
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP8821
—
SC
Enumeration date
01/15/2019
Last updated
07/13/2021
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