# AUGUSTINE HEALTH GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Inpatient Medicine Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548466006
- **Authorized official:** MS. ANGELA HAITHCOCK (PROJECT MANAGER)
- **Authorized official phone:** (803) 865-4780

## Contact information

- **Practice address:** 2435 FOREST DR, COLUMBIA, SC 29204-2026
- **Practice address phone:** (803) 256-5300
- **Mailing address:** PO BOX 601964, CHARLOTTE, NC 28260-1964
- **Mailing address phone:** (855) 477-2477
- **Mailing address fax:** (216) 472-2740

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/22/2007
- **Last updated:** 02/06/2012