Covered Entity Details

CH04041V FAMILY HEALTH CENTERS OF GEORGIA, INC., THE (Approved) - information as of 4/29/2025 11:56:50 PM

Main Details

Name

FAMILY HEALTH CENTERS OF GEORGIA, INC., THE

Subdivision Name

The Family Health Center of GA dba Georgia Center for Women at Peachtree

Type

HRSA-Funded Health Center

Site ID

BPS-H80-036256

340B ID

CH04041V

Grant Number

H80CS00485

Additional Details

Current Program Status

Approved

Registration Date

4/8/2025

Participating Start Date

7/1/2025

Participating Approval Date

4/25/2025

Last Recertification Date

Contacts

Authorizing Official

The Family Health Centers of Georgia Inc.
Michael Brooks, President & CEO
(404) 756-8732

Primary Contact

The Family Health Centers of GA
Sammy L King, CFO
(470) 603-7268

Addresses

Street Address

550 Peachtree Street NE STE 1250
Atlanta, GA 30308-2239

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
GA	003298958A	1790404457

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH040410	Active	BPS-H80-005006	THE FAMILY HEALTH CENTER AT WEST END	THE FAMILY HEALTH CENTER AT WEST END	868 York Ave SW	Atlanta	GA
CH04041J	Active	BPS-H80-012303	The Family Health Centers of Georgia, Inc	Family Health Center at Cobb	805 Campbell Hill Street	MARIETTA	GA
CH04041K	Terminated	BPS-H80-008876	The Family Health Centers of Georgia, Inc	Family Health Center @ Bolton Village	2011 Bolton Rd NW	Atlanta	GA
CH04041L	Active	BPS-H80-019457	Family Health Centers Of Georgia, Inc., The	The Family Health Center at North Clayton High School	1525 Norman Drive	College Park	GA
CH04041M	Terminated	BPS-H80-021880	Family Health Centers Of Georgia, Inc., The	The Family Health Center at KidCare	2565 Jolly Road	College Park	GA
CH04041N	Active	BPS-H80-019653	Family Health Centers Of Georgia, Inc., The	The Family Health Center at Douglas County Schools	8277 Connally Drive	Douglasville	GA
CH04041P	Terminated	BPS-H80-021896	Family Health Centers Of Georgia, Inc., The	The Family Health Center at KidCare	910 Dannon View Suite 2102	Atlanta	GA
CH04041Q	Active	BPS-H80-022251	Family Health Centers Of Georgia, Inc., The	The Family Health Center at College Park School-Based	2075 Princeton Avenue	College Park	GA
CH04041R	Active	BPS-H80-019456	Family Health Centers Of Georgia, Inc., The	The Family Health Center at Lake Forest	5920 Sandy Springs Circle	Sandy Springs	GA
CH04041S	Active	BPS-H80-009937	Family Health Centers Of Georgia, Inc., The	Mobile Medical and Dental Unit	868 york ave.	Atlanta	GA
CH04041T	Approved	BPS-H80-036109	FAMILY HEALTH CENTERS OF GEORGIA, INC., THE	Mobile Sprinter Medical Unit	868 York Ave SW	Atlanta	GA
CH04041U	Approved	BPS-H80-036108	FAMILY HEALTH CENTERS OF GEORGIA, INC., THE	Mobile Sprinter Medical Unit II	868 York Ave SW	Atlanta	GA
CH04041V	Approved	BPS-H80-036256	FAMILY HEALTH CENTERS OF GEORGIA, INC., THE	The Family Health Center of GA dba Georgia Center for Women at Peachtree	550 Peachtree Street NE STE 1250	Atlanta	GA
CH04041W	Approved	BPS-H80-037337	FAMILY HEALTH CENTERS OF GEORGIA, INC., THE	The Family Health Center at Banneker School-Based Health Center	6015 Feldwood Rd	Atlanta	GA
CH04041X	Approved	BPS-H80-039300	FAMILY HEALTH CENTERS OF GEORGIA, INC., THE	The Family Health Centers at Morrow	6685 Merchants Way	Morrow	GA
CH04041Y	Approved	BPS-H80-037726	FAMILY HEALTH CENTERS OF GEORGIA, INC., THE	The Family Health Centers of GA dba McDonough Children's Specialists	350 Huntington Place Ct	Mcdonough	GA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH040410	APAA LLC	D/B/A HOLIDAY PHARMACY	6815 N. DALE MABRY HIGHWAY	TAMPA	FL	33614	10/01/2013	10/01/2016
CH04041J	APAA LLC	D/B/A HOLIDAY PHARMACY	6815 N. DALE MABRY HIGHWAY	TAMPA	FL	33614	10/01/2013
CH04041K	APAA LLC	D/B/A HOLIDAY PHARMACY	6815 N. DALE MABRY HIGHWAY	TAMPA	FL	33614	10/01/2013	04/01/2021
CH040410	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 00079	2098 HIGHWAY 20 WEST	MCDONOUGH	GA	30253	07/01/2025
CH040410	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02088	6716 MT. ZION BOULEVARD	MORROW	GA	30260	07/01/2025
CH040410	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04549	8139 TARA BLVD.	JONESBORO	GA	30236	07/01/2025
CH040410	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05682	2 N. ZACK HINTON PARKWAY	MCDONOUGH	GA	30253	07/01/2025
CH040410	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 08395	2720 HIGHWAY 42 NORTH	MCDONOUGH	GA	30253	07/01/2025
CH040410	GEORGIA CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 8934	1870 HWY 81 EAST	MCDONOUGH	GA	30252	07/01/2025
CH040410	GEORGIA CVS PHARMACY, L.L.C.	CVS PHARMACY # 16793	1850 JONESBORO RD	MCDONOUGH	GA	30253	07/01/2025
CH040410	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04178	895 RALPH ABERNATHY BLVD., SW	ATLANTA	GA	30310	07/01/2025
CH040410	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02184	1029 FOREST PARKWAY	FOREST PARK	GA	30297	07/01/2025
CH040410	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2025
CH040410	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2025
CH040410	WALGREEN CO.	DBA: WALGREENS # 07394	3740 CASCADE RD SW	ATLANTA	GA	30331	07/01/2025
CH040410	WALGREEN CO.	DBA: WALGREENS # 09271	7935 TARA BLVD	JONESBORO	GA	30236-2205	07/01/2025
CH040410	WALGREEN CO.	COMMUNITY A WALGREENS PHARMACY #15304	1874 PIEDMONT AVE NE STE 100A	ATLANTA	GA	30324	07/01/2025
CH040410	WALGREEN CO.	COMMUNITY, A WALGREENS PHARMACY #21146	565 PEACHTREE ST NE STE B	ATLANTA	GA	30308	07/01/2025
CH040410	WALGREEN CO.	COMMUNITY A WALGREENS PHARMACY #21230	860 JOHNSON FERRY RD STE 230	SANDY SPRINGS	GA	30342-1453	07/01/2025
CH040410	WALGREEN CO.	DBA: WALGREENS #13873	2675 N DECATUR ROAD STE 101	DECATUR	GA	30033	07/01/2025
CH040410	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2025
CH040410	WALMART PHARMACY 10-7601	835 MARTIN LUTHER KING JR DR NW		ATLANTA	GA	30314	07/01/2025
CH040410	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	07/01/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Signed By	Insert	New Registration		Brooks, Michael President & CEO The Family Health Centers of Georgia Inc. 4047568732	4/25/2025 7:06 AM
Details	340B ID	Update	New Registration		CH04041V	4/25/2025 7:06 AM
Dates	Participating Approval Date	Update	New Registration		4/25/2025 7:06:47 AM	4/25/2025 7:06 AM
Details	State	Update	New Registration	Pending	Approved	4/25/2025 7:06 AM
Dates	Signed By Date	Update	New Registration		4/8/2025 3:37:45 PM	4/25/2025 7:06 AM
Dates	Start Date	Update	New Registration		7/1/2025 12:00:00 AM	4/25/2025 7:06 AM
Addresses	Main Address	Insert	New Registration		550 Peachtree Street NE STE 1250 Atlanta, GA 30308-2239	4/8/2025 3:37 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/8/2025 3:37 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		003298958A	4/8/2025 3:37 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		GA	4/8/2025 3:37 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1790404457	4/8/2025 3:37 PM
Medicaid Billing	NPI: State	Insert	New Registration		GA	4/8/2025 3:37 PM
Contacts	Authorizing Official	Insert	New Registration		Brooks, Michael President & CEO The Family Health Centers of Georgia Inc. 4047568732	4/8/2025 3:37 PM
Contacts	Primary Contact	Insert	New Registration		King, Sammy L CFO The Family Health Centers of GA 4706037268	4/8/2025 3:37 PM
Details	Assistance Received From Date	Insert	New Registration			4/8/2025 3:37 PM
Details	Assistance Received To Date	Insert	New Registration			4/8/2025 3:37 PM
Details	Last Recertification Date	Insert	New Registration			4/8/2025 3:37 PM
Details	Grant Number	Insert	New Registration		H80CS00485	4/8/2025 3:37 PM
Details	340B ID	Insert	New Registration			4/8/2025 3:37 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/8/2025 3:37 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/8/2025 3:37 PM
Details	Medicare Provider Number	Insert	New Registration			4/8/2025 3:37 PM
Details	Entity Name	Insert	New Registration		FAMILY HEALTH CENTERS OF GEORGIA, INC., THE	4/8/2025 3:37 PM
Details	NOFO Number	Insert	New Registration			4/8/2025 3:37 PM
Details	Program Code	Insert	New Registration		CH	4/8/2025 3:37 PM
Details	Entity Subname	Insert	New Registration		The Family Health Center of GA dba Georgia Center for Women at Peachtree	4/8/2025 3:37 PM
Dates	Participating Approval Date	Insert	New Registration			4/8/2025 3:37 PM
Details	State	Insert	New Registration		Pending	4/8/2025 3:37 PM
Dates	Registration Date	Insert	New Registration		4/8/2025 3:37:45 PM	4/8/2025 3:37 PM
Dates	Signed By Date	Insert	New Registration			4/8/2025 3:37 PM
Dates	Start Date	Insert	New Registration			4/8/2025 3:37 PM
Terminations	Termination Comments	Insert	New Registration			4/8/2025 3:37 PM
Terminations	Termination Date	Insert	New Registration			4/8/2025 3:37 PM
Terminations	Termination Effective Date	Insert	New Registration			4/8/2025 3:37 PM
Terminations	Termination Reason	Insert	New Registration			4/8/2025 3:37 PM

340B Drug Pricing Program Database