EAU CLAIRE COOPERATIVE HEALTH CENTER, INC. (NPI# 1457740789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457740789 |
| Entity Type | Organization |
| Organization Name | EAU CLAIRE COOPERATIVE HEALTH CENTER, INC. |
| Other Organization Name | EAU CLAIRE FAMILY DENTISTRY |
| Practice Address |
3800 N Main St Ste. C Columbia SC 29203-6414 |
| Mailing Address |
Po Box 3788 Columbia SC 29230-3788 |
| Practice Telephone | 8037053169 |
| Practice Fax Number | 8037053175 |
| Mailing Telephone | 8037335969 |
| Mailing Fax Number | 8037535591 |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2016-12-16 |
| Authorized Official Name | DELGAOD CANTAVE (CEO) |
| Authorized Official Telephone | 8037335969 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | ZA9183 | 05 |
| Other Name | Type Code |
|---|---|
| Eau Claire Family Dentistry | 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 |
| 1811294978 | Eau Claire Cooperative Health Center, Inc. | Clinic/Center | 3041 Old Eastover Road, Eastover, SC 29044-2417 | 2011-02-24 |
| 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 |
| 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 |
3800 N MAIN ST STE. C |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29203-6414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831573625 | Lindsay Mobley Hall | Dentist | 3800 N Main St, Suite C, Columbia, SC 29203-6414 | 2015-07-13 |
| 1639593866 | Tammie Mims | Physical Therapist | 3800 N Main St, Suite E, Columbia, SC 29203-6414 | 2014-02-07 |
| 1093093346 | Eau Claire Cooperative Health Center, Inc. | Podiatrist | 3800 N Main St, Ste.b, Columbia, SC 29203-6414 | 2011-08-03 |
| 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 | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184239832 | Adam Wesley Gadbois | Dentist | 220 Diego Dr, Columbia, MO 65203-4919 | 2020-09-10 |
| 1841803855 | Craig Thomas Luskey | Dentist | 4500 Stuart St Fl 3, Columbia, SC 29207-5700 | 2020-08-28 |
| 1710505169 | Dentists of Devine, PC | Dentist | 4600 Devine St Ste B, Columbia, SC 29205-3617 | 2020-07-13 |
| 1134745227 | Kayla White | Dentist | 1401 Forum Blvd Ste 203, Columbia, MO 65203-1915 | 2020-06-24 |
| 1962033001 | Ivy Creek Family Dentistry LLC | Dentist | 9007 Two Notch Rd Ste B, Columbia, SC 29223-5834 | 2020-01-28 |
| 1538701230 | Sulekha Agrawal Dmd LLC | Dentist | 9194 Red Branch Rd Ste A, Columbia, MD 21045-2005 | 2019-10-14 |
| 1619522794 | Timothy Drew Edwards | Dentist | 122 N. Brickyard Rd, Columbia, SC 29223 | 2019-08-06 |
| 1245885284 | Mana Shoeybi | Dentist | 6955 Oakland Mills Rd Ste 0, Columbia, MD 21045-5849 | 2019-08-06 |
| 1528628716 | Soh of Missouri Samson Liu PC | Dentist | 303 N Keene St # 202-210, Columbia, MO 65201-8050 | 2019-06-19 |
| 1417511783 | Molly Kayleen Pincelli | Dentist | Ph Usc Medical Group Dentistry, 10 Medical Park, Columbia, SC 29203 | 2019-04-23 |
| 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.