=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093622821
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CONWAY HOSPITAL, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/26/2026
-----------------------------------------------------
Last Update Date | 08/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1221 21ST AVE N
-----------------------------------------------------
City | MYRTLE BEACH
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29577-7402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-626-9379
-----------------------------------------------------
Fax | 843-448-0707
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 SINGLETON RIDGE RD ATTN CREDENTIALING
-----------------------------------------------------
City | CONWAY
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29526-9142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PAYER ENROLLMENT SUPERVISOR
-----------------------------------------------------
Name | MARY ELLEN ARTIOLI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 843-234-6946
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------