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Organization
AUGUSTINE HEALTH GROUP, LLC
Active
Organization
AUGUSTINE HEALTH GROUP, LLC
Active
Other names
Providence Psychiatric Consults
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY W. WHITAKER (MANAGER)
(806) 865-4798
Entity
Organization
Contact information
Practice address
114 GATEWAY CORPORATE BLVD, SUITE 425, COLUMBIA, SC 29203-9740
(803) 256-5300
Mailing address
PO BOX 60496, CHARLOTTE, NC 28260-0496
(803) 256-5300
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
19523
SC
Other
Enumeration date
06/22/2007
Last updated
04/29/2008
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