| Organization Name: | AUGUSTINE HEALTH GROUP, LLC |
| NPI Number: | 1578830279 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANGELA HAITHCOCK (PROJECT MANAGER) |
| Mailing Address: | 2351 Augusta Hwy Lexington |
| State: | SC US |
| Postal Code: | 290722213 |
| Phone Number: | 8038654780 |
| Fax Number: | 8038654932 |
| NPI Enumeration Date: | 11/23/2011 |
| NPI Last Update Date: | 11/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |