| Augustine Health Group, Llc | |
|
2601 Laurel St Suite 120 Columbia SC 29204-2033 | |
| (803) 254-7889 | |
| (803) 254-7893 |
| Full Name | Augustine Health Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2601 Laurel St, Columbia, South Carolina |
| Authorized Official Name and Position | Angela Haithcock (PROJECT MANAGER) |
| Authorized Official Contact | 8038654780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Augustine Health Group, Llc 114 Gateway Corporate Blvd Suite 425 Columbia SC 29203-9740 Ph: (803) 865-4780 | Augustine Health Group, Llc 2601 Laurel St Suite 120 Columbia SC 29204-2033 Ph: (803) 254-7889 |
| NPI Number | 1780998161 |
|---|---|
| Provider Enumeration Date | 07/28/2010 |
| Last Update Date | 02/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780998161 | NPI | - | NPPES |
| 052052 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 5205 (South Carolina) | Primary |
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