Providence Northeast Family Care

LBN: Augustine Health Group, Llc
Providence Northeast Family Care is an health care organization with primary practice located at 114 Gateway Corporate Blvd Suite 230, Columbia SC 29203-9740. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Augustine Health Group, Llc can be contacted via phone (803) 788-2277, or through Haithcock, Angela via phone (803) 865-4780.

Contact Information

Primary practice address
114 Gateway Corporate Blvd Suite 230 Columbia SC 29203-9740
Phone: (803) 788-2277
Fax: (803) 788-6508
Website:
Map and Directions
Authorized official contact:
Name: Haithcock, Angela
Phone: (803) 865-4780

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1437279122
LBN Legal business name Augustine Health Group, Llc
DBA Doing business as Providence Northeast Family Care
Authorized official Haithcock, Angela
Entity Organization
Organization subpart 1 No
Enumeration date Mar 29th, 2007
Last updated Feb 6th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437279122 NPPES
South Carolina MEDICAID GP4383

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