Providence Northeast Family Care At Lake Carolina

LBN: Augustine Health Group, Llc
Providence Northeast Family Care At Lake Carolina is an health care organization with primary practice located at 300 Long Pointe Ln Suite 130, Columbia SC 29229-7543. 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) 462-7193, or through Whitaker, Jeremy W via phone (803) 865-4798.

Contact Information

Primary practice address
300 Long Pointe Ln Suite 130 Columbia SC 29229-7543
Phone: (803) 462-7193
Fax: (803) 462-7163
Website:
Map and Directions
Authorized official contact:
Name: Whitaker, Jeremy W CPC
Phone: (803) 865-4798

Health care specialties

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

Profile Details

NPI number 1750401451
LBN Legal business name Augustine Health Group, Llc
DBA Doing business as Providence Northeast Family Care At Lake Carolina
Authorized official Whitaker, Jeremy W CPC
Entity Organization
Organization subpart 1 No
Enumeration date Mar 29th, 2007
Last updated Mar 7th, 2008 - about 17 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 1750401451 NPPES
South Carolina MEDICAID GP4545

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