| Eau Claire Cooperative Health Center ,inc. | |
|
115 Atrium Way Ste 120 Columbia SC 29223-6382 | |
| (803) 875-8020 | |
| (803) 626-0742 |
| Full Name | Eau Claire Cooperative Health Center ,inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 115 Atrium Way Ste 120, Columbia, South Carolina |
| Authorized Official Name and Position | Delgado Cantave (CEO) |
| Authorized Official Contact | 8037335969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eau Claire Cooperative Health Center ,inc. 169 Laurelhurst Ave Columbia SC 29210-3825 Ph: (803) 733-5969 | Eau Claire Cooperative Health Center ,inc. 115 Atrium Way Ste 120 Columbia SC 29223-6382 Ph: (803) 875-8020 |
| NPI Number | 1063159267 |
|---|---|
| Provider Enumeration Date | 05/18/2022 |
| Last Update Date | 05/18/2022 |
| Medicare PECOS PAC ID | 3274434220 |
|---|---|
| Medicare Enrollment ID | O20220630001243 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063159267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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