Provider Demographics
NPI:1285646083
Name:CONWAY HOSPITAL SERVICES
Entity Type:Organization
Organization Name:CONWAY HOSPITAL SERVICES
Other - Org Name:PALMETTO PULMONARY & SLEEP MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-347-2999
Mailing Address - Street 1:STE 104
Mailing Address - Street 2:4728 JENN DRIVE
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-5714
Mailing Address - Country:US
Mailing Address - Phone:843-236-8888
Mailing Address - Fax:843-236-5088
Practice Address - Street 1:128 PROFESSI PK DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8964
Practice Address - Country:US
Practice Address - Phone:843-247-2999
Practice Address - Fax:843-347-4746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20362207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4505Medicaid
SCH12974Medicare UPIN
SC7844Medicare PIN