# AUGUSTINE HEALTH GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AUGUSTINE HEALTH GROUP, LLC
- **Other names:** Associates in Internal Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1093966400
- **Legal business name:** AUGUSTINE HEALTH GROUP, LLC
- **Authorized official:** ANGELA HAITHCOCK (PROJECT MANAGER)
- **Authorized official phone:** (803) 865-4780

## Contact information

- **Practice address:** 2701 MIDDLEBURG DRIVE, COLUMBIA, SC 29204
- **Practice address phone:** (803) 254-2786
- **Practice address fax:** (803) 254-9015
- **Mailing address:** 114 GATEWAY CORPORATE BLVD., SUITE \#425, COLUMBIA, SC 29203
- **Mailing address phone:** (803) 865-4780
- **Mailing address fax:** (803) 865-4932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 22699 | SC | Yes |

## Other

- **Enumeration date:** 10/03/2008
- **Last updated:** 01/11/2012