Pruitthealth - Conway, LLC
Organization Active NPI Skilled Nursing Facility · Conway, SC
NPI 1124595863 · NPPES record last updated May 29, 2019
Key facts
- NPI
- 1124595863
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- PRUITTHEALTH - CONWAY, LLC
- Practice address
- 2379 Cypress Cir
Conway, SC 29526-8921 - Phone
- (843) 347-8179
- NPI assigned
- Oct 31, 2018
- Organization subpart
- No
Authorized official
- Name
- Neil L. Pruitt Jr.
- Title
- Chairman and Ceo of Manager
- Phone
- (770) 279-6200
Facilities with the same owner 121
Affiliated clinicians 2
-
Jonathan Daly, D.O.
Medicare Care Compare: Nursing home
- Listed as
- PruittHealth- Conway At Conway Medical Center
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 16, 1989
- Medicare certification status
- Active
- Certified beds
- 88 · 80.7 residents per day on average
- Chain
- Pruitthealth
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D1006866 | Pruitthealth - Conway, LLC | Certificate of waiver | Dec 2, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Skilled nursing facility certification: CCN 425173
- Legal name
- PRUITTHEALTH - CONWAY, LLC
- Doing business as
- PRUITTHEALTH - CONWAY AT CONWAY MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 16, 1989
- Last certification
- May 13, 2025
- Beds
- 88
- Ownership / control type
- Corporation
- Multi-facility organization
- PruittHealth
- Organization structure
- LLC · Proprietary
- Incorporated
- Sep 4, 2018 in SC
- Enrollment address
- 2379 Cypress Cir
Conway, SC 29526-8921 - Nursing home name
- PRUITTHEALTH- CONWAY AT CONWAY MEDICAL CENTER
- Affiliated entity
- PRUITTHEALTH
All disclosed owners & managing parties 20
| Name | Role | Since | Share |
|---|---|---|---|
| Uhs- Pruitt Holdings Inc |
5% Or Greater Indirect Ownership Interest | Sep 4, 2018 | 100% |
| Indirect Ownership Interest | Sep 4, 2019 | 99% | |
| |
Adp of the SNF | Aug 12, 2020 | |
| Indirect Ownership Interest | Aug 12, 2020 | 6.29% | |
| |
Indirect Ownership Interest | Aug 12, 2020 | 2.4% |
| United Health Services Inc |
5% Or Greater Indirect Ownership Interest | Sep 4, 2018 | 99% |
| Indirect Ownership Interest | Sep 4, 2018 | 99% | |
| |
Adp of the SNF | Aug 18, 2020 | |
| Indirect Ownership Interest | Aug 18, 2020 | 1.59% | |
| |
Adp of the SNF | Nov 27, 2013 | |
| Philip W. Small |
Corporate Director |
Nov 27, 2013 | |
| |
Adp of the SNF | Nov 11, 2019 | |
| Lisa P Hamby Trust |
5% Or Greater Indirect Ownership Interest | Jun 22, 2021 | 21.44% |
| Adp of the SNF | Jun 22, 2021 | ||
| Indirect Ownership Interest | Jun 22, 2021 | 21.44% | |
| Neil Little Pruitt |
Corporate Officer |
Nov 27, 2013 | 1% |
| Direct Ownership Interest | Nov 27, 2013 | 1% | |
| |
Adp of the SNF | Nov 27, 2013 | |
| United Health Services of South Carolina Inc |
5% Or Greater Direct Ownership Interest | Sep 4, 2018 | 99% |
| Direct Ownership Interest | Sep 4, 2018 | 99% | |
| Neil L Pruitt Jr Trust |
5% Or Greater Indirect Ownership Interest | Jun 22, 2021 | 42.86% |
| Adp of the SNF | Jun 22, 2021 | ||
| Indirect Ownership Interest | Jun 22, 2021 | 42.86% | |
| NWP 2020 Child TR Fbo Neil L Pruitt Jr |
Indirect Ownership Interest | Aug 12, 2020 | 6.29% |
| |
Adp of the SNF | Oct 8, 2018 | |
| Indirect Ownership Interest | Apr 12, 2024 | ||
| Cindy Robbins |
Operational/Managerial Control | Sep 23, 2024 | |
| Adp of the SNF | Mar 28, 2025 | ||
| Nancy W Pruitt |
Corporate Officer |
Nov 27, 2013 | |
| |
Adp of the SNF | Mar 28, 2025 | |
| Pruitthealth Consulting Services Inc |
Adp of the SNF | Nov 26, 2013 | |
| J Paige Pruitt Trust |
5% Or Greater Indirect Ownership Interest | Jun 22, 2021 | 21.44% |
| Adp of the SNF | Jun 22, 2021 | ||
| Indirect Ownership Interest | Jun 22, 2021 | 21.44% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181207000980 | SC | Part a Provider - Skilled Nursing Facility | 4880938414 | Practice locations: Conway, SC |
National Provider Directory
Locations
2379 Cypress Cir
Conway, SC 29526
Phone (413) 219-5530
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
2379 Cypress Cir
Conway, SC 29526-8921
Mailing address
1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (770) 279-6200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0518NH | Medicaid | SC |
Other names
- PruittHealth - Conway at Conway Medical Center
Other providers in Conway, SC
- Karissa Marie Proctor
- Cole Prosser
- Melissa Courtney Prothro
- Proxsys RX - SC, LLC
- PRS 5, LLC
- Pruitthealth Therapy Services, Inc.
- Angelina Pucciarelli
- Cecelia Catherine Pueschel
- Pshanda Chante Pugh
- Pamela Pyle
All providers in Conway, SC · Skilled Nursing Facility in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.