Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
AUGUSTINE HEALTH GROUP, LLC
Active
Organization
AUGUSTINE HEALTH GROUP, LLC
Active
Other names
Providence Northeast Family Care at Lake Carolina
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY W WHITAKER CPC (MANAGER)
(803) 865-4798
Entity
Organization
Contact information
Practice address
300 LONG POINTE LN, SUITE 130, COLUMBIA, SC 29229-7543
(803) 462-7193
(803) 462-7163
Mailing address
PO BOX 60496, CHARLOTTE, NC 28260-0496
(803) 462-7193
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4545
—
SC
Enumeration date
03/29/2007
Last updated
03/07/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up