Organization
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Active
Parent organization
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Other names
Innovations Ridgewood
Organization subpart
Yes
Provider details
NPI number
Legal business name
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Authorized official
DR. STUART A HAMILTON M.D. (CEO)
(803) 733-5969
Entity
Organization
Contact information
Practice address
4801 MONTICELLO RD, COLUMBIA, SC 29203-4124
(803) 714-0266
(803) 252-1968
Mailing address
PO BOX 3788, COLUMBIA, SC 29230-3788
(803) 733-5969
(803) 217-0026
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4350
—
SC
Enumeration date
05/17/2013
Last updated
02/03/2022
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