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General NPI Number Information
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NPI Number | 1467772400
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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 | 06/01/2010
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 1213 ELM STREET
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City | AYNOR
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State | SC
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Zip | 29511
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Country | US
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Telephone | 843-358-5806
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Fax | 843-358-9205
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Provider Business Mailing Address
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Address Line | 300 SINGLETON RIDGE RD ATTENTION PNS CREDENTIALING
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City | CONWAY
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State | SC
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Zip | 29526-9142
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Country | US
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Telephone | 843-234-6946
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MARY ELLEN ARTIOLI
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Credential |
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Telephone | 843-234-6946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 828
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License Number State | SC
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