NPIMap

Conway Hospital, Inc.

Organization Active NPI Family Medicine Physician · Myrtle Beach, SC

NPI 1629570387 · NPPES record last updated Dec 12, 2023

Key facts

NPI
1629570387
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
CONWAY HOSPITAL, INC.
Practice address
4022 Postal Way
Myrtle Beach, SC 29579-3537
Phone
(843) 236-0000
Fax
(843) 236-6191
NPI assigned
Mar 8, 2018
Organization subpart
No

Authorized official

Name
Mary Ellen Artioli
Title
Credentialing Specialist
Phone
(843) 234-6946

Other NPIs on the same Medicare enrollment 40

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 40

Corporate family (same tax ID) 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D1014415CMC Primary Care Postal Way
4022 Postal Way, Myrtle Beach, SC 29579		Certificate of waiverSep 7, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031201000111 SC Part B Supplier - Clinic/Group Practice 7113839606 Receives reassigned benefits from 148 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Conway, SC; Surfside Beach, SC; Myrtle Beach, SC; Murrells Inlet, SC; Little River, SC; Florence, SC

National Provider Directory

Tax ID family
Conway Hospital Inc (34 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X Yes
Medical Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP		 363AM0700X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LF0000X

Addresses

Primary practice location

4022 Postal Way
Myrtle Beach, SC 29579-3537

Mailing address

300 Singleton Ridge Road
Attention PNS Credentialing
Myrtle Beach, SC 29526-9142
Phone (843) 234-6946

Other identifiers

IdentifierTypeStateIssuer
GP8567MedicaidSC

Other names

  • CMC Primary Care Postal Way Doing business as

Other providers in Myrtle Beach, SC

All providers in Myrtle Beach, SC · Family Medicine Physician in South Carolina

Sources for this page

Verify at the official NPI Registry.