Provider Demographics
NPI:1881565919
Name:NORTH AUGUSTA HEALTH CENTER
Entity type:Organization
Organization Name:NORTH AUGUSTA HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MAGGI
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-603-4800
Mailing Address - Street 1:460 W MARTINTOWN RD STE 3106
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-3106
Mailing Address - Country:US
Mailing Address - Phone:803-279-9901
Mailing Address - Fax:
Practice Address - Street 1:460 W MARTINTOWN RD STE 3160
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-3106
Practice Address - Country:US
Practice Address - Phone:803-279-9901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty