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EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC.
NPI 1700728052
Family Medicine - Adolescent Medicine in Columbia, SC

Active since April 07, 2026
4809 MONTICELLO RD, COLUMBIA, SC 29203(803) 888-1106(803) 602-0035 Get Directions Write a Review

NPPES record last updated: April 7, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Eau Claire Cooperative Health Center ,inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC. (NPI 1700728052) is a healthcare organization registered as an adolescent medicine in Columbia, South Carolina and active in the NPI registry since April 2026. The organization lists Kimberly M Tilley, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1700728052
Entity TypeOrganization
Primary Taxonomy207QA0000X
Legal Business NameEAU CLAIRE COOPERATIVE HEALTH CENTER ,INC.
Location Address4809 MONTICELLO RDColumbia, SC 29203-4124
Mailing Address4809 Monticello RdColumbia, SC 29203-4124 · (803) 888-1106 · Fax (803) 602-0035
Phone(803) 888-1106
Fax(803) 602-0035
Organization SubpartNo
Authorized OfficialKimberly M TilleyCredentialing Manager · (804) 306-1203
Enumeration DateApril 7, 2026
NPPES CertifiedApril 7, 2026
✔ NPI 1700728052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0000X
Definition
A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
4809 MONTICELLO RD, Columbia, SC 29203
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eau Claire Cooperative Health Center ,inc.'s NPI number?

The NPI number for Eau Claire Cooperative Health Center ,inc. is 1700728052. It was assigned to this organization in the NPPES registry on April 7, 2026.

Where is Eau Claire Cooperative Health Center ,inc. located?

Eau Claire Cooperative Health Center ,inc. is located at 4809 Monticello Rd, Columbia, SC 29203. The listed phone number is (803) 888-1106.

What is Eau Claire Cooperative Health Center ,inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adolescent Medicine, with taxonomy code 207QA0000X.

When was this NPI record last updated?

The NPPES record for Eau Claire Cooperative Health Center ,inc. was last updated on April 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.