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Organization
EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC.
Active
Organization
EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC.
Active
Other names
Cooperative Health Community Care Mobile Unit
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY M TILLEY (SR. CREDENTIALING SPECIALIST)
(803) 530-7855
Entity
Organization
Contact information
Practice address
120 W CHURCH STREET, LEESVILLE, SC 29070
(803) 532-2208
Mailing address
120 W CHURCH STREET, LEESVILLE, SC 29070
(803) 532-2208
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/09/2026
Last updated
09/09/2026
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