Waverly Family Practice
LBN: Eau Claire Cooperative Health Center, Inc.
Waverly Family Practice is an health care organization with primary practice located at 1228 Harden St Ste.C, Columbia SC 29204-1800. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty.
Eau Claire Cooperative Health Center, Inc. can be contacted via phone (803) 748-1181, or through Cantave, Delgado via phone (803) 733-5969.
Contact Information
Primary practice address
1228 Harden St Ste.C
Columbia SC 29204-1800
Phone: (803) 748-1181
Fax: (803) 748-1185
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X |
Profile Details
| NPI number | 1053622050 |
|---|---|
| LBN Legal business name | Eau Claire Cooperative Health Center, Inc. |
| DBA Doing business as | Waverly Family Practice |
| Authorized official | Cantave, Delgado |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 24th, 2010 |
| Last updated | Feb 3rd, 2022 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053622050 | NPPES |
| South Carolina | MEDICAID | CBP018 | |
| South Carolina | MEDICAID | FQC031 | |
| South Carolina | MEDICAID | FQC164 |
Popular Providers
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Eau Claire Cooperative Health Center ,Inc.
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Eau Claire Cooperative Health Center, Inc.
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Eau Claire Cooperative Health Center, Inc.
6904 N Main St Suite 100, Columbia SC 29203-3852