Organization
CONWAY HOSPITAL, INC.
Active
Other names
CMC Pediatrics Church Street
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
(843) 234-6946
Entity
Organization
Contact information
Practice address
2701 CHURCH ST, STE F, CONWAY, SC 29526-4422
(843) 369-0024
(843) 369-0072
Mailing address
300 SINGLETON RIDGE RD, ATTENTION PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PG2221
—
SC
Enumeration date
05/17/2024
Last updated
07/02/2024
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