Conway Hospital Inc
Organization Active NPI Pediatrics Physician · Myrtle Beach, SC
NPI 1760630966 · NPPES record last updated Feb 5, 2021
Key facts
- NPI
- 1760630966
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- CONWAY HOSPITAL INC
- Practice address
- 4022 Postal Way
Suite C
Myrtle Beach, SC 29579-3537 - Phone
- (843) 903-4111
- Fax
- (843) 903-4242
- NPI assigned
- Sep 3, 2008
- Organization subpart
- No
Authorized official
- Name
- Mary Ellen Artioli
- Title
- Credentialing Specialist
- Phone
- (843) 234-6946
Other NPIs on the same Medicare enrollment 40
Corporate family (same tax ID) 33
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes | ||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
4022 Postal Way
Suite C
Myrtle Beach, SC 29579-3537
Mailing address
300 Singleton Ridge Rd
Attn: Patient Accounting
Conway, SC 29526-9142
Phone (843) 234-6946
Other practice location 1
5010 Carolina Forest Blvd
Myrtle Beach, SC 29579-3579
Phone (843) 236-2700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP4505 | Medicaid | SC |
Other names
- CMC PEDIATRICS CAROLINA FOREST
- CMC PEDIATRICS TOWNE CENTER
- CONWAY HOSPITAL COMMUNITY SERVICES
- CPG PEDIATRICS CAROLINA FOREST
Other providers in Myrtle Beach, SC
- Monica Beatrice Constantinescu
- Consulting With Science LLC
- Consulting With Science LLC
- Kyra Elizabeth Contris
- Convenient Concierge Healthcare
- Conway Hospital, Inc.
- Conway Hospital, Inc.
- Conway Hospital, Inc.
- Conway Hospital, Inc.
- Conway Hospital, Inc.
All providers in Myrtle Beach, SC · Pediatrics Physician 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 Feb 5, 2021. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.