Healthcare Provider Details

I. General information

NPI: 1447497540
Provider Name (Legal Business Name): CONWAY HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2009
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

847 FARRAR DR UNIT 2
CONWAY SC
29526-8747
US

IV. Provider business mailing address

300 SINGLETON RIDGE RD ATTN: CREDENTIALING
CONWAY SC
29526-9142
US

V. Phone/Fax

Practice location:
  • Phone: 843-234-9700
  • Fax: 843-234-6896
Mailing address:
  • Phone: 843-234-6946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

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