EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC. – NPI #1700728052
Family Medicine

A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.

Health Care Provider Taxonomy Code for Family Medicine

EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC. is a provider located in COLUMBIA, SC. NPPES recently assigned the NPI number 1700728052 to EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC. on April 07, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207QA0000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Adolescent Medicine

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC. below.

NPI Profile for
EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC.

NPI Number
1700728052
Enumeration Date

(about 2 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC.
Primary location
4809 MONTICELLO RD
COLUMBIA, SC 29203-4124
Phone: (803) 888-1106 Fax: (803) 602-0035
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
KIMBERLY TILLEY
CREDENTIALING MANAGER
Phone: (804) 306-1203
Updated
Certification Date
Apr 07, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0000X
- Family Medicine / Adolescent Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.