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General NPI Number Information
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NPI Number | 1043632805
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Entity Type | Organization
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Legal Business Name | CONWAY HOSPITAL COMMUNITY SERVICES
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Dates
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Enumeration Date | 01/14/2014
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Last Update Date | 01/15/2014
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Provider Practice Location Address
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Address Line | 8004 MYRTLE TRACE DR
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City | CONWAY
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State | SC
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Zip | 29526-8945
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Country | US
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Telephone | 843-347-7216
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Fax | 843-347-7218
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Provider Business Mailing Address
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Address Line | PO BOX 50760
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City | MYRTLE BEACH
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State | SC
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Zip | 29579-0013
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Country | US
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Telephone | 843-234-6827
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Fax |
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Authorized Official
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Title or Position | VP FISCAL SERVICES
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Name | MR. BRETT BARR
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Credential |
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Telephone | 843-234-5139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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