Organization · Type 2 NPI

Eau Claire Cooperative Health Center, Inc.

Federally Qualified Health Center (FQHC) · Blair, SC

NPI number 1841689288 Active

Practice location

1978 State Highway 215 S
Blair, SC 29015-9443

Call (803) 402-6782 Map

Fax (803) 635-6628

Mailing address

PO Box 3788
Columbia, SC 29230-3788

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

NPI record

NPI: 1841689288
Entity type: Organization (Type 2)
Issued: Jan 22, 2015
Last updated: Oct 12, 2026
Status: Active

Other names

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Lake Monticello Family Practice @mccrorey Liston · doing business as
Lake Monticello Family Practice @mccrorey Liston · doing business as

Authorized official

Dana Schultz
CFO
(305) 587-7375

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1841689288

Eau Claire Cooperative Health Center, Inc.'s National Provider Identifier is 1841689288, issued on Jan 22, 2015. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Blair, SC. The record was last updated on Oct 12, 2026.