EAU CLAIRE COOPERATIVE HEALTH CENTER, INC. (NPI# 1811294978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811294978 |
| Entity Type | Organization |
| Organization Name | EAU CLAIRE COOPERATIVE HEALTH CENTER, INC. |
| Other Organization Name | EASTOVER FAMILY PRACTICE |
| Practice Address |
3041 Old Eastover Road Eastover SC 29044-2417 |
| Mailing Address |
Po Box 3788 Columbia SC 29230-3788 |
| Practice Telephone | 8033538741 |
| Practice Fax Number | 8033538789 |
| Mailing Telephone | 8037335969 |
| Mailing Fax Number | 8032525624 |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2018-10-30 |
| Authorized Official Name | DELGADO CANTAVE (CEO) |
| Authorized Official Telephone | 8037335969 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
SC | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | CBP018 | 05 | |
| SC | FQC031 | 05 | |
| SC | FQC132 | 05 |
| Other Name | Type Code |
|---|---|
| Eastover Family Practice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033760483 | Eau Claire Cooperative Health Center, Inc. | Pharmacy | 3041 Old Eastover Rd, Eastover, SC 29044-8303 | 2019-09-26 |
| 1023407996 | Eau Claire Cooperative Health Center, Inc. | Pediatrics | 4601 Monticello Road, Columbia, SC 29203 | 2015-01-15 |
| 1093051245 | Eau Claire Cooperative Health Center, Inc. | Clinic/Center | 4206 N Main St, Columbia, SC 29203-5864 | 2012-12-17 |
| 1326267592 | Eau Claire Cooperative Health Center, Inc. | Clinic/Center | 9017 State Highway 215 S, Jenkinsville, SC 29065-9428 | 2007-04-25 |
| 1346249430 | Eau Claire Cooperative Health Center, Inc. | Family Medicine | 1228 Harden St, Columbia, SC 29204-1800 | 2005-07-20 |
| 1891148367 | Eau Claire Cooperative Health Center, Inc. | Dentist | 8063 Edmund Hwy, Pelion, SC 29123-9805 | 2016-07-19 |
| 1588053938 | Eau Claire Cooperative Health Center, Inc. | Family Medicine | 2025 Main St, Columbia, SC 29201-2125 | 2015-01-22 |
| 1457740789 | Eau Claire Cooperative Health Center, Inc. | Clinic/Center | 3800 N Main St, Ste. C, Columbia, SC 29203-6414 | 2015-01-09 |
| 1902176183 | Eau Claire Cooperative Health Center, Inc. | Clinic/Center | 9023 Garners Ferry Rd, Hopkins, SC 29061-9540 | 2012-01-05 |
| 1093093346 | Eau Claire Cooperative Health Center, Inc. | Podiatrist | 3800 N Main St, Ste.b, Columbia, SC 29203-6414 | 2011-08-03 |
| Street Address |
3041 OLD EASTOVER ROAD |
| City | EASTOVER |
| State | SC |
| Zip Code | 29044-2417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730669789 | Eau Claire Cooperative Health Center Inc. | Pharmacy | 3041 Old Eastover Road, Eastover, SC 29044 | 2018-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427470251 | Carla Nadine Boyd | Home Health Aide | 1156 B Old Mcgraw Rd, Eastover, SC 29044 | 2014-01-14 |
| 1982691796 | Vanessa K Wideman | Family Medicine | 1325 S Carolina Rd Ste 11, Eastover, SC 29044 | 2005-10-06 |
| 1821290818 | Marguerite Lovett Knox | Nurse Practitioner | 1325 S Carolina Rd Ste 29, Eastover, SC 29044-5000 | 2007-06-03 |
| 1962914036 | Alex Ramon Wright | Social Worker | 860 S Carolina Rd, Eastover, SC 29044-5052 | 2017-10-30 |
| 1609328590 | Deidra Swails | Social Worker | 860 S Carolina Rd # 6, Eastover, SC 29044-5052 | 2016-10-26 |
| 1033760483 | Eau Claire Cooperative Health Center, Inc. | Pharmacy | 3041 Old Eastover Rd, Eastover, SC 29044-8303 | 2019-09-26 |
| 1881204899 | Wanda Kay Fulton | Nurse Practitioner | 3041 Old Eastover Rd, Eastover, SC 29044-8303 | 2020-08-04 |
| 1871133728 | Melissa R. Scott | Nurse Practitioner | 3041 Old Eastover Rd, Eastover, SC 29044-8303 | 2020-01-08 |
| 1811496862 | Tonia Michele Wood | Registered Nurse | 120 Clarkson St, Eastover, SC 29044-8769 | 2018-02-06 |
| 1073982195 | Chelsea Baker | Physician Assistant | 120 Clarkson St, Eastover, SC 29044-8769 | 2015-09-18 |
| Find all providers in zip 29044 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
| 1124627153 | Hopehealth Inc | Clinic/Center | 2155 Paxville Hwy, Manning, SC 29102-5074 | 2020-10-21 |
| 1083228779 | Sandhills Medical Foundation Inc | Clinic/Center | 103 Main Street South, Bethune, SC 29009 | 2020-09-01 |
| 1235753914 | Eau Claire Cooperative Health Center Inc. | Clinic/Center | 4605 Monticello Rd Bldg C, Columbia, SC 29203-4156 | 2020-05-29 |
| 1982248852 | Regenesis Organization Community Health Center | Clinic/Center | 115 Thomas St Ste B, Union, SC 29379-2147 | 2019-11-04 |
| 1720636012 | Genesis Health Care, Inc | Clinic/Center | 115 Exchange St, Darlington, SC 29532-3203 | 2019-08-29 |
| 1063079549 | Health Care Partners of South Carolina, Inc. | Clinic/Center | 243 Singleton Ridge Rd, Units E&f, Conway, SC 29526-8391 | 2019-05-21 |
| 1043775703 | Rural Health Services Inc | Clinic/Center | 4200 Whiskey Rd, Aiken, SC 29803-8534 | 2019-02-07 |
| 1295202356 | Eau Claire Cooperative Health Center Inc. | Clinic/Center | 2600 Wheat St, Columbia, SC 29205-2315 | 2018-10-26 |
| 1215410667 | Low Country Health Care System | Clinic/Center | 19340 Solomon Blatt Ave N, Blackville, SC 29817-2304 | 2018-09-12 |
| 1922584481 | Sandhills Medical Foundation, Inc. | Clinic/Center | 290 Market Street, Ruby, SC 29741 | 2018-07-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.