Organization
CONWAY HOSPITAL, INC.
Active
Other names
CMC Primary Care Surfside Beach
Organization subpart
No
Provider details
NPI number
Authorized official
BRET BARR (CEO)
(843) 347-8114
Entity
Organization
Contact information
Practice address
1413 HIGHWAY 17 N, SURFSIDE BEACH, SC 29575-6012
(843) 238-5654
(843) 238-1624
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
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP8566
—
SC
Enumeration date
03/08/2018
Last updated
10/25/2021
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