Organization
AUGUSTINE HEALTH GROUP, LLC
Active
Parent organization
SISTERS OF CHARITY PROVIDENCE HOSPITALS
Other names
Providence Family Medicine Lexington
Organization subpart
Yes
Provider details
NPI number
Legal business name
SISTERS OF CHARITY PROVIDENCE HOSPITALS
Authorized official
MS. ANGELA HAITHCOCK (PROJECT MANAGER)
(803) 865-4780
Entity
Organization
Contact information
Practice address
2351 AUGUSTA HWY, LEXINGTON, SC 29072-2213
(803) 865-4780
(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
207Q00000X
Family Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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