EAU CLAIRE COOPERATIVE HEALTH CENTER INC. NPI 1265745202

NPI Information

EAU CLAIRE COOPERATIVE HEALTH CENTER, INC. is a federally qualified health center (fqhc) clinic center in Columbia, SC. EAU CLAIRE COOPERATIVE HEALTH CENTER, INC. NPI is 1265745202. The provider is registered as an organization entity type.
The provider Is Doing Business As Sterling Sharpe Pediatric Center.

The provider's business location address is:

4605 MONTICELLO RD
BLDG A, STE.1
COLUMBIA, SC
ZIP 29203-156
Phone: (803) 252-7001
Fax: (803) 252-5219

The provider's authorized official is Delgado Cantave .
The authorized official title is Ceo and has the following contact phone number (803) 733-5969.

The CLIA number assigned to this NPI record is 42D0249427 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/20/2010 and was last updated on 2/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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