Organization
AUGUSTINE HEALTH GROUP LLC
Active
Other names
Providence Womens Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA B HAM CPA (MGR GENERAL ACCOUNTING)
(803) 865-4583
Entity
Organization
Contact information
Practice address
114 GATEWAY CORP BLVD, SUITE 350 AUGUSTINE HEALTH GROUP LLC, COLUMBIA, SC 29203-9802
(803) 865-4780
(803) 865-4932
Mailing address
114 GATEWAY CORP BLVD, SUITE 425, COLUMBIA, SC 29203-9802
(803) 865-4780
(803) 865-4932
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25087
SC
207V00000X
Obstetrics & Gynecology Physician
Primary
21388
SC
Other
Enumeration date
04/07/2006
Last updated
04/20/2008
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