Healthcare Provider Details

I. General information

NPI: 1790306363
Provider Name (Legal Business Name): CONWAY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 16TH AVE
CONWAY SC
29526-3454
US

IV. Provider business mailing address

1219 16TH AVE
CONWAY SC
29526-3454
US

V. Phone/Fax

Practice location:
  • Phone: 843-488-3535
  • Fax: 843-488-3435
Mailing address:
  • Phone: 843-488-3535
  • Fax: 843-488-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MAGDY HANNA
Title or Position: OWNER
Credential:
Phone: 732-266-9359