Organization
AUGUSTINE HEALTH GROUP LLC
Active
Organization
AUGUSTINE HEALTH GROUP LLC
Active
Parent organization
AUGUSTINE HEALTH GROUP LLC
Other names
Providence Physical Medicine and Rehabilitation
Organization subpart
Yes
Provider details
NPI number
Legal business name
AUGUSTINE HEALTH GROUP LLC
Authorized official
MRS. REGINA JOY FRAME (CREDENTIALING COORDINATOR)
(803) 865-4780
Entity
Organization
Contact information
Practice address
114 GATEWAY CORPORATE BLVD, SUITE 440, COLUMBIA, SC 29203
(803) 865-4780
(803) 865-4932
Mailing address
114 GATEWAY CORPORATE BLVD, SUITE 440, COLUMBIA, SC 29203
(803) 865-4780
(803) 865-4932
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4785
—
SC
Enumeration date
03/10/2008
Last updated
03/10/2008
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