# AUGUSTINE HEALTH GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AUGUSTINE HEALTH GROUP LLC
- **Other names:** Providence Physical Medicine and Rehabilitation
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508036203
- **Legal business name:** AUGUSTINE HEALTH GROUP LLC
- **Authorized official:** MRS. REGINA JOY FRAME (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (803) 865-4780

## Contact information

- **Practice address:** 114 GATEWAY CORPORATE BLVD, SUITE 440, COLUMBIA, SC 29203
- **Practice address phone:** (803) 865-4780
- **Practice address fax:** (803) 865-4932
- **Mailing address:** 114 GATEWAY CORPORATE BLVD, SUITE 440, COLUMBIA, SC 29203
- **Mailing address phone:** (803) 865-4780
- **Mailing address fax:** (803) 865-4932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/10/2008
- **Last updated:** 03/10/2008