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Contact Information

EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
9017 STATE HIGHWAY 215 S
JENKINSVILLE, SC29065-9428
 Phone: 803-298-2068
 Fax: 803-298-2069
 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 # 1326267592
LBN Legal business name EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Authorized official DELGADO CANTAVE - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 04/25/2007
Last updated 02/03/2022 - About 4 years ago
Identifiers
SC Medicaid CBP018
SC Medicaid FQC031
SC Medicaid FQC126
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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