EAU CLAIRE COOPERATIVE HEALTH CENTERS, INC. (NPI# 1760871115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760871115 |
| Entity Type | Organization |
| Organization Name | EAU CLAIRE COOPERATIVE HEALTH CENTERS, INC. |
| Other Organization Name | ST. LAWRENCE PLACE |
| Practice Address |
2400 Waites Rd Columbia SC 29204-1325 |
| Mailing Address |
Po Box 3788 Columbia SC 29230-3788 |
| Practice Telephone | 8037084861 |
| Practice Fax Number | 8037535591 |
| Mailing Telephone | 8037335969 |
| Mailing Fax Number | 8037535591 |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |
| Authorized Official Name | STUART A. HAMILTON (CEO) |
| Authorized Official Telephone | 8037335969 |
| Authorized Official Credential | M.D. |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| St. Lawrence Place | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679962021 | Eau Claire Cooperative Health Centers, Inc. | Family Medicine | 3821 W Beltline Blvd, Columbia, SC 29204-1567 | 2015-01-22 |
| 1841689288 | Eau Claire Cooperative Health Centers, Inc. | Clinic/Center | 1978 State Highway 215 S, Blair, SC 29015-9443 | 2015-01-22 |
| 1700122967 | Eau Claire Cooperative Health Centers, Inc. | Clinic/Center | 6904 N Main St, Suite 100, Columbia, SC 29203-3852 | 2012-12-17 |
| 1952727158 | Eau Claire Cooperative Health Centers, Inc. | Clinic/Center | 2712 Middleburg Dr, Ste. 101, Columbia, SC 29204-2415 | 2014-03-12 |
| 1427494392 | Eau Claire Cooperative Health Centers, Inc. | Clinic/Center | 4801 Monticello Rd, Columbia, SC 29203-4124 | 2013-05-17 |
| 1467795815 | Eau Claire Cooperative Health Centers, Inc. | Clinic/Center | 4605 Monticello Rd, Bldgb, Ste.2, Columbia, SC 29203-4156 | 2013-04-04 |
| 1760703250 | Eau Claire Cooperative Health Centers, Inc. | Clinic/Center | 755 Us Highway 21 S, Ridgeway, SC 29130-6844 | 2010-06-18 |
| 1750555298 | Eau Claire Cooperative Health Centers, Inc. | Clinic/Center | 1332 Pickens St, Columbia, SC 29201-3430 | 2008-04-16 |
| 1558320960 | Eau Claire Cooperative Health Centers, Inc. | Clinic/Center | 1520 Laurel St, Columbia, SC 29201-2623 | 2006-03-23 |
| Street Address |
2400 WAITES RD |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204-1325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992215149 | Ricardo Colon II | Registered Nurse | 3000 Hampton Street, Columbia, SC 29204 | 2017-10-02 |
| 1780113522 | Carla Star Noe | Registered Nurse | Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 | 2017-06-06 |
| 1124568514 | Kristy L Thompson | Nurse Practitioner | 1655 Bernardin Ave Ste 240, Columbia, SC 29204 | 2017-03-03 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1851748974 | Shaquita Banks | Counselor | 1810 Allen Benedict Ct, A1, Columbia, SC 29204 | 2016-05-18 |
| 1265804835 | Premier Care, LLC | Case Management | 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 | 2015-10-22 |
| 1023492287 | Shamiquia N. Mcpherson | Counselor | 1627 Auburn St., Columbia, SC 29204 | 2015-07-16 |
| 1285028449 | The Columbia Free Medical Clinic, Inc. | Clinic/Center | 1875 Harden Street, Columbia, SC 29204 | 2015-03-26 |
| 1629473459 | Leslie Wilson | Counselor | 2323 Lady Street, Columbia, SC 29204 | 2014-10-22 |
| 1053728683 | Candyce Sutton | Social Worker | 1135 Carter Street, Columbia, SC 29204 | 2014-07-15 |
| Find all providers in zip 29204 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447868005 | Brittany Mechelle Waterworth | Family Medicine | 3700 I 70 Dr Se Ste 106, Columbia, MO 65201-6587 | 2020-07-20 |
| 1730706839 | John James Gannon | Family Medicine | Prisma Health Medical Group Family Medicine, 3209 Colonial Drive, Columbia, SC 29203 | 2020-07-06 |
| 1053938852 | Garrison Glenn Rice | Family Medicine | Prisma Health Medical Group Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-29 |
| 1457977563 | Jenny Tatiana Gonzalez Guzman | Family Medicine | Prisma Health Family Medical Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-24 |
| 1942825500 | Jarvis Jamal Johnson | Family Medicine | Prisma Health Family Medicine Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-10 |
| 1386268183 | Nicolas Anthony Limogiannis | Family Medicine | Prisma Health Medical Group Family Medicine Center, 3209 Colonial Drive, Columbia, SC 29203 | 2020-06-08 |
| 1730724220 | Luci Lee Redman Cassella | Family Medicine | 8900 Columbia 100 Parway Suite G, Columbia, MD 21045 | 2019-11-08 |
| 1275177420 | Palmetto Primary Care Physicians | Family Medicine | 1415 Blanding St Ste 2, Columbia, SC 29201-2922 | 2019-10-31 |
| 1558919852 | Synergos Medical, LLC | Family Medicine | 1703 Oak Cliff Pl, Columbia, MO 65203-4719 | 2019-08-29 |
| 1972156982 | Maury Regional Medical Group, Inc | Family Medicine | 2478 Nashville Hwy Ste A, Columbia, TN 38401-0634 | 2019-07-18 |
| 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.