Organization
AUGUSTINE HEALTH GROUP, LLC
Active
Other names
Providence Internal Medicine Northeast
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA HAITHCOCK (PROJECT MANAGER)
(803) 865-4780
Entity
Organization
Contact information
Practice address
114 GATEWAY CORPORATE BLVD, SUITE 330, COLUMBIA, SC 29203-9740
(803) 865-4514
(803) 865-4932
Mailing address
114 GATEWAY CORPORATE BLVD, SUITE 425, COLUMBIA, SC 29203-9740
(803) 865-4780
(803) 865-4932
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
12/15/2010
Last updated
02/06/2012
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