Eau Claire Cooperative Health Center Inc. | |
4605 Monticello Rd Bldg C Columbia SC 29203-4156 | |
(803) 356-7102 | |
Not Available |
Full Name | Eau Claire Cooperative Health Center Inc. |
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Speciality | Clinic/Center |
Location | 4605 Monticello Rd Bldg C, 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 |
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Eau Claire Cooperative Health Center Inc. 169 Laurelhurst Ave Columbia SC 29210-3825 Ph: (803) 733-5969 | Eau Claire Cooperative Health Center Inc. 4605 Monticello Rd Bldg C Columbia SC 29203-4156 Ph: (803) 356-7102 |
NPI Number | 1235753914 |
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Provider Enumeration Date | 05/29/2020 |
Last Update Date | 05/29/2020 |
Medicare PECOS PAC ID | 3274434220 |
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Medicare Enrollment ID | O20200813003593 |
Identifier | Type | State | Issuer |
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1235753914 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Lagniappe Medical Clinics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 74 Polo Rd, Columbia, SC 29223 Phone: 803-419-7780 Fax: 803-419-7781 | |