Organization
CONWAY HOSPITAL, INC.
Active
Other names
CMC Occupational Health
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
(843) 234-6946
Entity
Organization
Contact information
Practice address
4022 POSTAL WAY STE 101, MYRTLE BEACH, SC 29579-3537
(843) 234-7360
(843) 234-2886
Mailing address
300 SINGLETON RIDGE RD, ATTN 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
—
—
363AM0700X
Medical Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PG0773
—
SC
Enumeration date
12/07/2021
Last updated
11/04/2022
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