Healthcare Provider Details

I. General information

NPI: 1740139567
Provider Name (Legal Business Name): CONQUISTA MYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 TIMBER OAKS DR
MYRTLE BEACH SC
29588-9388
US

IV. Provider business mailing address

263 TIMBER OAKS DR
MYRTLE BEACH SC
29588-9388
US

V. Phone/Fax

Practice location:
  • Phone: 843-446-2480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: