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DSH420049 CONWAY HOSPITAL (Active)
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Main Details
Name
CONWAY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH420049
Medicare Provider Number
420049
Additional Details
Current Program Status
Active
Registration Date
4/10/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/17/2019
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Conway Hospital
Angela Williford, Chief Administrative Officer
(843) 347-8166
Primary Contact
Conway Hospital Inc dba Conway Medical Center
Brandie Nicole Thompson, Ambulatory Pharmacy Supervisor
(843) 455-8570
Addresses
Street Address
300 SINGLETON RIDGE ROAD
CONWAY, SC 29526
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start date 7/1/2005, Termination 7/1/2017, Reinstatement 7/1/2019
04/17/2019
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