Conway Manor, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCF-899 Issued in SC

Legal business name

CONWAY MANOR, LLC

Practice address

3300 4TH Ave
Conway, SC 29527-6002

Phone

(843) 248-5728

Fax

(843) 248-6698

NPI assigned

May 22, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Raymond Tiller, NHA

Title

Administrator

Phone

(843) 248-5728

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1639123748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 4TH AVE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295276002",
            "telephone_number": "843-248-5728",
            "fax_number": "843-248-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 4TH AVE",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295276002",
            "telephone_number": "843-248-5728",
            "fax_number": "843-248-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "TILLER",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "843-248-5728",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SC",
            "license": "NCF-899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0899NF",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Conway Hospital, Inc.
• Conway Hospital, Inc.
• Conway Hospital, Inc.
• Conway Hospital, Inc.
• Conway Internists, P.a.
• Conway Obstectrics and Gynecology
• Conway Pediatrics,PA
• Conway Pharmacy LLC
• Conway Podiatry Center PC
• Stephen Bradley Cook, M.ED.

• Skilled Nursing Facility in Conway, SC
• Providers in Conway, SC by specialty
• Skilled Nursing Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.