Healthcare Provider Details

I. General information

NPI: 1750466223
Provider Name (Legal Business Name): CONWAY HOSPITAL LONG TERM CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SINGLETON RIDGE RD
CONWAY SC
29526-9142
US

IV. Provider business mailing address

PO BOX 829
CONWAY SC
29528-0829
US

V. Phone/Fax

Practice location:
  • Phone: 843-347-8179
  • Fax: 843-347-8003
Mailing address:
  • Phone: 843-347-8179
  • Fax: 843-347-8003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAURA FOWLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 842-347-8179