NPIMap

Organization Active NPI

Eau Claire Cooperative Health Center ,Inc.

Doing business as Cooperative Health @ CAMH

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
National Provider Identifier
1588375653
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC.
Doing business as
Cooperative Health @ CAMH
Practice address
2715 Colonial Dr
Columbia, SC 29203-6818
Phone
(803) 758-6676
Fax
(803) 887-4049
NPI assigned
Dec 9, 2022
Last updated
Oct 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dana Schultz
Title
Cfo
Phone
(305) 587-7375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2715 Colonial Dr
Columbia, SC 29203-6818

Mailing address

169 Laurelhurst Ave
Columbia, SC 29210-3825
Phone (803) 733-5969

Other names 1

  • Cooperative Health @ CAMH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040114000335 SC Part B Supplier - Clinic/Group Practice 3274434220 Receives reassigned benefits from 153 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, SC; Eastover, SC; Hopkins, SC; Jenkinsville, SC; Leesville, SC; Little Mountain, SC; Newberry, SC; Pelion, SC…
O20230202000007 SC Part A Provider - Federally Qualified Health Center (FQHC) 3274434220 Practice locations: Columbia, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1588375653. Details of each certification follow.

Federally qualified health center certification: CCN 421089

Legal name
EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 29, 2023
Last certification
Jun 29, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 14, 1992 in SC
Enrollment address
2715 Colonial Dr
Columbia, SC 29203-6818

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Winnsboro Pediatrics Famil44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

12 Meadowlake Rd
Blair, SC 29015
Phone (803) 945-7595

1228 Harden St
Ste A
Columbia, SC 29204
Phone (803) 722-1565

1228 Harden St
Ste B
Columbia, SC 29204
Phone (803) 744-0540

1228 Harden St
Ste C
Columbia, SC 29204
Phone (803) 748-1181

1520 Laurel St
Columbia, SC 29201
Phone (803) 256-3400

2117 Gervais St
Columbia, SC 29204
Phone (803) 744-0540

217 Gervais St
Columbia, SC 29201
Phone (803) 748-1181

2600 Wheat St
Columbia, SC 29205
Phone (803) 748-7002

9019 Garners Ferry Rd
Hopkins, SC 29061
Phone (803) 227-6890

9023 Garners Ferry Rd
Hopkins, SC 29061
Phone (803) 978-1848

338 E Columbia Ave
#B
Leesville, SC 29070
Phone (803) 532-1580

2525 Kinard St
Newberry, SC 29108
Phone (803) 276-4860

407 N Brown St
West Columbia, SC 29169
Phone (803) 722-1352

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Karena S White Individual W-2 Managing Employee Jan 1, 2018
Junior Delgado Cantave Individual Corporate Director Jan 1, 2016
W-2 Managing Employee Jan 1, 2016
Operational/Managerial Control Jan 1, 2016

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Eau Claire Cooperative Health Center, Inc.Columbia, SC, CCN 421843 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2019
Eastover Family PracticeEastover, SC, CCN 421960 Federally qualified health center Operational/Managerial Control Jan 26, 2012
Pediatrics of NewberryNewberry, SC, CCN 421970 Federally qualified health center 5% Or Greater Direct Ownership Interest Jul 1, 2014
Waverly Women's Health & Internal MedicineBatesburg Leesville, SC, CCN 421974 Federally qualified health center 5% Or Greater Direct Ownership Interest Jun 1, 2010
Eau Claire PodiatryColumbia, SC, CCN 421968 Federally qualified health center 5% Or Greater Direct Ownership Interest Mar 7, 2022
Sterling Sharpe PediatricsSuite 1, SC, CCN 421972 Federally qualified health center 5% Or Greater Direct Ownership Interest Nov 4, 2014
Pelion Pediatrics Family & DentalPelion, SC, CCN 421977 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 19, 2012
Brookland Community PediatricsWest Columbia, SC, CCN 421978 Federally qualified health center 5% Or Greater Direct Ownership Interest Jul 1, 2010
Pediatrics of Batesburg-LeesburgBatesburg-Leesville, SC, CCN 421980 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 30, 2012
Eau Claire Walk-inColumbia, SC, CCN 421023 Federally qualified health center 5% Or Greater Direct Ownership Interest Mar 7, 2022
Five Points Behavioral Health at Hand Middle SchoolColumbia, SC, CCN 421064 Federally qualified health center Operational/Managerial Control Jan 1, 2016
Eau Claire Cooperative Health Center, Inc.Little Mountain, SC, CCN 421068 Federally qualified health center Operational/Managerial Control Jan 1, 2016
Columbia Community Family PracticeColumbia, SC, CCN 871035 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2016
Advantage Eye CareColumbia, SC, CCN 871038 Federally qualified health center 5% Or Greater Direct Ownership Interest Jun 1, 2022

Practitioners & affiliated clinicians

Practitioners 160

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 160

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791763200000",
    "number": "1588375653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 LAURELHURST AVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292103825",
            "telephone_number": "803-733-5969",
            "fax_number": "803-753-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036818",
            "telephone_number": "803-758-6676",
            "fax_number": "803-887-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAU CLAIRE COOPERATIVE HEALTH CENTER ,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-09",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "305-587-7375"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cooperative Health @ CAMH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.