EAU CLAIRE COOPERATIVE HEALTH CENTER INC. (NPI# 1538674254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538674254 |
| Entity Type | Organization |
| Organization Name | EAU CLAIRE COOPERATIVE HEALTH CENTER INC. |
| Other Organization Name | CAYCE WEST COLUMBIA PRIMARY CARE |
| Practice Address |
407 N Brown St West Columbia SC 29169-5710 |
| Mailing Address |
Po Box 3788 Columbia SC 29230-3788 |
| Practice Telephone | 8039958936 |
| Practice Fax Number | 8039958851 |
| Mailing Telephone | 8037335969 |
| Mailing Fax Number | 8037535591 |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2019-01-02 |
| Authorized Official Name | KIMBERLY M WOODSON (SR. CREDENTIALING SPECIALIST) |
| 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) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Cayce West Columbia Primary Care | Doing Business As Name - Organization |
| 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 |
| 1295202356 | Eau Claire Cooperative Health Center Inc. | Clinic/Center | 2600 Wheat St, Columbia, SC 29205-2315 | 2018-10-26 |
| 1669029294 | Eau Claire Cooperative Health Center Inc. | Family Medicine | 99 N Mill St, Little Mountain, SC 29075-8788 | 2019-08-19 |
| 1730669789 | Eau Claire Cooperative Health Center Inc. | Pharmacy | 3041 Old Eastover Road, Eastover, SC 29044 | 2018-08-20 |
| 1306185509 | Eau Claire Cooperative Health Center Inc. | Clinic/Center | 1228 Harden St, Ste.b, Columbia, SC 29204-1800 | 2013-02-07 |
| Street Address |
407 N BROWN ST |
| City | WEST COLUMBIA |
| State | SC |
| Zip Code | 29169-5710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497163547 | Marie Jose Moubarak | Pediatrics | 407 N Brown St, West Columbia, SC 29169 | 2014-07-31 |
| 1942855986 | Jamil'ya Alexis Swygert | Nurse Practitioner | 407 N Brown St, West Columbia, SC 29169-5710 | 2019-08-06 |
| 1295184935 | Brittany Pointer | Social Worker | 407 N Brown St, West Columbia, SC 29169-5710 | 2016-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960726 | Jerry Scott Oreilly | Physical Therapy Assistant | 100 Dreher Rd, Suite 100, West Columbia, SC 29169 | 2020-07-23 |
| 1134759921 | A&m Medical, LLC | Durable Medical Equipment & Medical Supplies | 1053 Sunset Boulevard, West Columbia, SC 29169 | 2020-01-21 |
| 1750946067 | First Physical Therapy, LLC | Clinic/Center | 100 Dreher Rd., Suite 100, West Columbia, SC 29169 | 2019-05-02 |
| 1295217545 | Tynaka Kwans Wilson | Nurse Practitioner | Sc House Calls Inc, 1053 Center Street, West Columbia, SC 29169 | 2018-09-04 |
| 1588183826 | Kimberly Jane Jennings | Registered Nurse | 1052 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-09-19 |
| 1164943213 | Jacob Luke Wayland | Emergency Medicine | Lexington Medical Center-emergency Medicine Dept, 2720 Sunset Blvd, West Columbia, SC 29169 | 2017-06-29 |
| 1740721232 | Heather Detwiler | Physical Therapy Assistant | 2705 Leaphart Rd., Carolina Gardens, West Columbia, SC 29169 | 2017-03-16 |
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1407252331 | Sandy Frye Boone | Counselor | 2318 Sunset Blvd # 2a, West Columbia, SC 29169 | 2014-11-04 |
| Find all providers in zip 29169 | ||||
| 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 |
|---|---|---|---|---|
| 1629381678 | Eau Claire Cooperative Health Center, Inc. | Clinic/Center | 500 N 12th St, West Columbia, SC 29169-6502 | 2010-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | ||||
| City | WEST COLUMBIA |
| Zip Code | 29169 |
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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.