EAU CLAIRE COOPERATIVE HEALTH CENTER,INC (NPI# 1780788430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780788430 |
Entity Type | Organization |
Organization Name | EAU CLAIRE COOPERATIVE HEALTH CENTER,INC |
Other Organization Name | COOPERATIVE HEALTH PHARMACY |
Practice Address |
4605 Monticello Rd Columbia SC 29203-4156 |
Practice Telephone | 8032523770 |
Practice Fax Number | 8032527443 |
Mailing Telephone | 8032523770 |
Mailing Fax Number | 8032527443 |
Enumeration Date | 2006-09-12 |
Last Update Date | 2020-08-22 |
Authorized Official Name | DR. STUART HAMILTON (CEO) |
Authorized Official Telephone | 8032523770 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 183500000X | Pharmacist | 50006332 | SC | Pharmacy Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
SC | 463323 | 05 | |
SC | DE2076 | 05 |
Other Name | Type Code |
---|---|
Cooperative Health Pharmacy | Doing Business As Name - Organization |
Street Address |
4605 MONTICELLO RD |
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 |
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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 |
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Taxonomy Code | 183500000X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
NPI | Name | Taxonomy | Address | Enumeration |
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1093316648 | Jaime Walker | Pharmacist | 8910 Route 108 Ste C, Columbia, MD 21045-2151 | 2020-11-02 |
1093327629 | Andrew Swensen | Pharmacist | 1202 South James Campbell Blvd, Columbia, TN 38401 | 2020-08-17 |
1588218028 | John Calvin Thorne Iv | Pharmacist | 175 Forum Drive, Columbia, SC 29229 | 2019-08-01 |
1821640046 | Maximilian Pettis | Pharmacist | 8940 Old Annapolis Rd Ste B, Columbia, MD 21045-2129 | 2019-07-09 |
1306401625 | Kayla Anne Wolcott | Pharmacist | Moncrief Army Hospital Outpatient Pharmacy 1 Ft Jackson, Columbia, SC 29207 | 2019-05-02 |
1578022513 | Nara Lee | Pharmacist | 525 Wotan Rd, Columbia, SC 29229-3347 | 2019-03-19 |
1184193542 | Helen Hoffman Coleman | Pharmacist | 16 Berryhill Road, Ste 109, Columbia, SC 29210 | 2018-11-15 |
1689149791 | Ashton Preslar | Pharmacist | 612 Whaley St Apt 135, Columbia, SC 29201-6323 | 2018-10-05 |
1013490390 | Crystal Cierra Graves | Pharmacist | 1 Windsor Cv Ste 306-2, Columbia, SC 29223-1833 | 2018-09-12 |
1891277505 | Daniel Long | Pharmacist | 630 Kilbourne Road, Columbia, SC 29205 | 2018-08-30 |
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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.