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Contact Information

EAU CLAIRE COOPERATIVE HEALTH CENTER, INC
1136 KINCAID BRIDGE RD
STE. A
WINNSBORO, SC29180-7116
 Phone: 803-635-1052
 Fax: 803-712-9724
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
Indicates primary specialty

NPI Profile & details for EAU CLAIRE COOPERATIVE HEALTH CENTER, INC

NPI Number 1003113168
LBN Legal business name EAU CLAIRE COOPERATIVE HEALTH CENTER, INC
Authorized official KIMBERLY TILLEY - (SR. CREDENTIALING SPECIALIST)
Entity Organization
Organization subpart 1 No
Enumeration date 02/24/2011
Last updated 08/14/2025 - About 10 months ago
Identifiers
SC Medicaid CBP018
SC Medicaid FQC031
SC Medicaid FQC133
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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