MEDICARE: CONWAY HOSPITAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner
2	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760630966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONWAY HOSPITAL INC

Provider Business Mailing Address
First Line	:	300 SINGLETON RIDGE RD
Second Line	:	ATTN: PATIENT ACCOUNTING
City	:	CONWAY
State	:	SC
Zip	:	29526-9142
Country	:	US
Telephone Number	:	843-234-6946
Fax Number	:	843-234-6990

Provider Business Practice Location Address
First Line	:	4022 POSTAL WAY
Second Line	:	SUITE C
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-3537
Country	:	US
Telephone Number	:	843-903-4111
Fax Number	:	843-903-4242

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	MARY ELLEN ARTIOLI
Credential	:
Telephone Number	:	843-234-6946

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	02/05/2021

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Directions to “CONWAY HOSPITAL INC ” Practice Location

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