Healthcare Provider Details

I. General information

NPI: 1245026061
Provider Name (Legal Business Name): CONWAY HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SINGLETON RIDGE RD UNIT 104
CONWAY SC
29526-9142
US

IV. Provider business mailing address

300 SINGLETON RIDGE RD ATTENTION CREDENTIALING
CONWAY SC
29526-9142
US

V. Phone/Fax

Practice location:
  • Phone: 843-347-8071
  • Fax: 843-347-8309
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARY ELLEN ARTIOLI
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 843-234-6946