# AUGUSTINE HEALTH GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Psychiatric Consults
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639375199
- **Authorized official:** MR. JEREMY W. WHITAKER (MANAGER)
- **Authorized official phone:** (806) 865-4798

## Contact information

- **Practice address:** 114 GATEWAY CORPORATE BLVD, SUITE 425, COLUMBIA, SC 29203-9740
- **Practice address phone:** (803) 256-5300
- **Mailing address:** PO BOX 60496, CHARLOTTE, NC 28260-0496
- **Mailing address phone:** (803) 256-5300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084F0202X | Forensic Psychiatry Physician | 19523 | SC | Yes |

## Other

- **Enumeration date:** 06/22/2007
- **Last updated:** 04/29/2008