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DSH420049G CONWAY HOSPITAL (Active)
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Main Details
Name
CONWAY HOSPITAL
Subdivision Name
CMC Imaging Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH420049G
Medicare Provider Number
420049
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/9/2020
Participating Start Date
4/1/2020
Participating Approval Date
3/10/2020
Last Recertification Date
8/26/2024
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
801 Farrar Drive
Conway, SC 29526
Billing Address
Conway Medical Center
300 Singleton Ridge Road
Conway, SC 29526
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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