EAU CLAIRE COOPERATIVE HEALTH CENTER, INC (NPI# 1992018949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992018949 |
| Entity Type | Organization |
| Organization Name | EAU CLAIRE COOPERATIVE HEALTH CENTER, INC |
| Other Organization Name | EAU CLAIRE BEHAVIORAL MEDICINE |
| Practice Address |
4605 Monticello Rd Building B, Ste.1 Columbia SC 29203-4156 |
| Mailing Address |
Po Box 3788 Columbia SC 29230-3788 |
| Practice Telephone | 8037140266 |
| Practice Fax Number | 8037536333 |
| Mailing Telephone | 8037535591 |
| Mailing Fax Number | 8037535591 |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2016-12-16 |
| Authorized Official Name | DELGADO CANTAVE (CEO) |
| Authorized Official Telephone | 8037335969 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | FQC187 | 05 | |
| SC | FQC031 | 05 | |
| SC | CBP018 | 05 |
| Other Name | Type Code |
|---|---|
| Eau Claire Behavioral Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659657682 | Eau Claire Cooperative Health Center, Inc | Clinic/Center | 8063 Edmund Hwy, Pelion, SC 29123-9805 | 2011-10-21 |
| 1447561527 | Eau Claire Cooperative Health Center, Inc | Clinic/Center | 4605 Monticello Rd, Bldg A, Ste.3, Columbia, SC 29203-4156 | 2010-06-23 |
| Street Address |
4605 MONTICELLO RD BUILDING B, STE.1 |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29203-4156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215937784 | Stuart Arnim Hamilton | Pediatrics | 4605 Monticello Rd, Eau Claire Cooperative Health Center, Columbia, SC 29203-4156 | 2005-07-27 |
| 1558992701 | Milissa Pauling Davis | Nurse Practitioner | 4605 Monticello Rd, Columbia, SC 29203-4156 | 2020-01-27 |
| 1295127868 | Paul Potylicki | Counselor | 4605 Monticello Rd, Bldg B, Ste.1, Columbia, SC 29203-4156 | 2015-02-19 |
| 1497150262 | Ruth-narumi Amador | Counselor | 4605 Monticello Rd, Bldg B, Ste.1, Columbia, SC 29203-4156 | 2014-10-23 |
| 1467795815 | Eau Claire Cooperative Health Centers, Inc. | Clinic/Center | 4605 Monticello Rd, Bldgb, Ste.2, Columbia, SC 29203-4156 | 2013-04-04 |
| 1982951000 | Julie Lynn Brasher | Nurse Practitioner | 4605 Monticello Rd, Columbia, SC 29203-4156 | 2012-08-08 |
| 1700168028 | Donald R Sampson | Internal Medicine | 4605 Monticello Rd, Columbia, SC 29203-4156 | 2011-09-13 |
| 1720367170 | Tonna L Coleman | Physician Assistant | 4605 Monticello Rd, Columbia, SC 29203-4156 | 2011-08-16 |
| 1861798845 | Elizabeth Wagoner Knight | Nurse Practitioner | 4605 Monticello Rd, Columbia, SC 29203-4156 | 2011-02-08 |
| 1265745202 | Eau Claire Cooperative Health Center, Inc. | Clinic/Center | 4605 Monticello Rd, Bldg A, Ste.1, Columbia, SC 29203-4156 | 2010-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475284 | Matthew Leon Brigmon | Surgery | 2 Richland Medical Park, Suite 300, Columbia, SC 29203 | 2020-10-23 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1790302362 | Klariz Teves Tucker | Internal Medicine | Internal Medcine Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-30 |
| 1811514482 | Esther Ruth Swan | Psychiatry & Neurology | Prisma Health General Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1447877014 | Jordan Kaitlyn Merrels | Psychiatry & Neurology | Prisma Health Medical Group General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-30 |
| 1306463187 | Jessica Leigh Watson | Psychiatry & Neurology | Prisma Health General Psychiatry, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-29 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1053938977 | Rachel Ellen Harper | Obstetrics & Gynecology | The Womens Center, 1801 Sunset Drive, Columbia, SC 29203 | 2020-06-26 |
| 1609493592 | Elizabeth Marie Kern | Orthopaedic Surgery | Prisma Health Medical Group Orthopedic Center, 2 Medical Park, Ste 105, Columbia, SC 29203 | 2020-06-26 |
| 1891312799 | Kathryn Victoria Steverson | Psychiatry & Neurology | Prisma Health Medical Group Psychiatry Center, 15 Medical Park, Ste 141, Columbia, SC 29203 | 2020-06-26 |
| Find all providers in zip 29203 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235753914 | Eau Claire Cooperative Health Center Inc. | Clinic/Center | 4605 Monticello Rd Bldg C, Columbia, SC 29203-4156 | 2020-05-29 |
| 1407487382 | Family First Health Corporation | Clinic/Center | 430 Walnut St, Columbia, PA 17512-1295 | 2020-01-30 |
| 1295202356 | Eau Claire Cooperative Health Center Inc. | Clinic/Center | 2600 Wheat St, Columbia, SC 29205-2315 | 2018-10-26 |
| 1689160939 | Maury Regional Hospital | Clinic/Center | 98 Experiment Station Lane, Columbia, TN 38401-4700 | 2018-07-10 |
| 1285188466 | Family First Health Corporation | Clinic/Center | 369 Locust St, First Floor, Columbia, PA 17512-1383 | 2016-08-05 |
| 1699157461 | Cumberland Family Medical Center, Inc. | Clinic/Center | 870 Indian Dr, Columbia, KY 42728-1813 | 2015-06-29 |
| 1164804720 | Cumberland Family Medical Center, Inc. | Clinic/Center | 158 Colonel Casey Drive, Columbia, KY 42728 | 2015-06-19 |
| 1790170389 | Maury Regional Hospital | Clinic/Center | 854 W James M Campbell Blvd Ste 301, Columbia, TN 38401-4659 | 2015-04-01 |
| 1760871115 | Eau Claire Cooperative Health Centers, Inc. | Clinic/Center | 2400 Waites Rd, Columbia, SC 29204-1325 | 2015-01-22 |
| 1093051245 | Eau Claire Cooperative Health Center, Inc. | Clinic/Center | 4206 N Main St, Columbia, SC 29203-5864 | 2012-12-17 |
| Find all providers in COLUMBIA | ||||
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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.