Organization
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Active
Other names
Innovations Greenview
Organization subpart
No
Provider details
NPI number
Authorized official
DELGADO CANTAVE (CEO)
(803) 733-5969
Entity
Organization
Contact information
Practice address
6904 N MAIN ST, SUITE 100, COLUMBIA, SC 29203-3852
(803) 735-8307
(803) 735-8668
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
12/17/2012
Last updated
02/03/2022
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