Provider Demographics
NPI:1902949852
Name:AUGUSTA HEALTH CARE INC
Entity Type:Organization
Organization Name:AUGUSTA HEALTH CARE INC
Other - Org Name:AUGUSTA HEALTH PRESCRIPTION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT-PROFESSIONAL SERVICE
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:CRABTREE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, MHA, FACHE
Authorized Official - Phone:540-332-4800
Mailing Address - Street 1:70 MEDICAL CENTER CIR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2273
Mailing Address - Country:US
Mailing Address - Phone:540-332-5946
Mailing Address - Fax:540-332-5948
Practice Address - Street 1:70 MEDICAL CENTER CIR
Practice Address - Street 2:SUITE 112
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2273
Practice Address - Country:US
Practice Address - Phone:540-332-5946
Practice Address - Fax:540-332-5948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010032383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4828868OtherNABP
VA8506191Medicaid
VA30015159510056Medicaid