OrganizationActive
Eau Claire Cooperative Health Center, Inc.
NPI 1841689288 · Federally Qualified Health Center (FQHC) · Blair, SC
Provider details
- NPI number
- 1841689288
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Delgado Cantave, Ceo(803) 733-5969
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1978 State Highway 215 S
Blair, SC 29015-9443
Phone: (803) 402-6782
Fax: (803) 635-6628
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 3788
Columbia, SC 29230-3788
Other names (DBA / former)
- Doing business as
- Lake Monticello Family Practice @mccrorey Liston
- Doing business as
- Lake Monticello Family Practice @mccrorey Liston
Registry dates
- Enumerated
- 2015-01-22
- Last updated
- 2022-02-10
- Certified
- 2022-02-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.