Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eau Claire Cooperative Health Center , Inc

Organization Adolescent Medicine (Family Medicine) Physician · NPI 1700728052

Eau Claire Cooperative Health Center , Inc is an Adolescent Medicine (Family Medicine) Physician in Columbia, South Carolina. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4809 Monticello Rd
Columbia, SC 29203-4124
Phone: (803) 888-1106
Fax: (803) 602-0035
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adolescent Medicine (Family Medicine) Physician (primary) Taxonomy 207QA0000X

Record details

NPI number1700728052
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Tilley — Sr. Credentialing Specialist · (803) 530-7855
NPI enumeratedApril 7, 2026
Last updated in NPPESAugust 4, 2026
Certification dateAugust 4, 2026
Mailing address4809 Monticello Rd, Columbia, SC 29203-4124

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