Covered Entity Details

CH04049F CURTIS V COOPER PRIMARY HEALTH CARE INC (Terminated) - information as of 5/7/2025 10:46:51 PM

Main Details

Name

CURTIS V COOPER PRIMARY HEALTH CARE INC

Subdivision Name

Curtis V. Cooper Primary Health Care, Inc.

Type

HRSA-Funded Health Center

Site ID

BPS-H80-012346

340B ID

CH04049F

Grant Number

H80CS00082

Additional Details

Current Program Status

Terminated

Registration Date

12/14/2017

Participating Start Date

1/1/2018

Participating Approval Date

12/14/2017

Last Recertification Date

2/4/2024

Termination Date
Termination Reason

1/1/2025
Site closure

Contacts

Authorizing Official

Curtis V. Cooper Primary Health Care, inc.
Albert B. Grandy JR., CEO
(912) 527-1117

Primary Contact

Curtis V. Cooper Primary Health care, Inc.
Earlene J Daniels, Chief Financial Officer
(912) 527-1088

Addresses

Street Address

800 E. 70th St.,
Savannah, GA 31405

Billing Address

Curtis V.Cooper Primary Health Care, Inc.
106 E. Broad Street
Sa, GA 31401

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?
No

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
CH040490	Active	BPS-H80-005195	CURTIS V. COOPER PRIMARY HEALTH CARE, INC.	FORMERLY WESTSIDE URBAN HLTH CTRS, INC.	106 EAST BROAD STREET	SAVANNAH	GA
CH04049A	Active	BPS-H80-004846	CURTIS V. COOPER PRIMARY HEALTH CARE, INC.	FORMERLY WESTSIDE-URBAN HEALTH CENTER	2 ROBERTS STREET	SAVANNAH	GA
CH04049D	Active	BPS-H80-012404	CURTIS V COOPER PRIMARY HEALTH CARE INC	Curtis V. Cooper Primary Health Care	349 W Bryan St	Savannah	GA
CH04049E	Active	BPS-H80-014305	CURTIS V COOPER PRIMARY HEALTH CARE INC	Curtis V. Cooper Women's Health Care Center	5354 Reynolds St STE 420	Savannah	GA
CH04049F	Terminated	BPS-H80-012346	CURTIS V COOPER PRIMARY HEALTH CARE INC	Curtis V. Cooper Primary Health Care, Inc.	800 E. 70th St.,	Savannah	GA
CH04049G	Terminated	BPS-H80-030370	CURTIS V COOPER PRIMARY HEALTH CARE INC	Chatham Behavioral Health Crisis Center	2121 Derenne Ave	Savannah	GA
CH04049H	Active	BPS-H80-021338	CURTIS V COOPER PRIMARY HEALTH CARE INC	CVC MOBILE HEALTH VAN	106 E. Broad St	Savannah	GA
CH04049J	Active	BPS-H80-028132	CURTIS V COOPER PRIMARY HEALTH CARE INC	Curtis V. Cooper Primary Health Care, Inc	400 E Broad St	Savannah	GA
CH04049K	Active	BPS-H80-029423	CURTIS V COOPER PRIMARY HEALTH CARE INC	Curtis V. Cooper Primary Health Care, Inc.	3219 College St	Savannah	GA
CH04049L	Active	BPS-H80-036861	CURTIS V COOPER PRIMARY HEALTH CARE INC	Curtis V. Cooper Primary Health Care, Inc.	244 Ledford St	Pembroke	GA
CH04049M	Active	BPS-H80-032087	CURTIS V COOPER PRIMARY HEALTH CARE INC	Jackson Dental Center -CVC	1501 Abercorn Street	Savannah	GA
CH04049N	Active	BPS-H80-036255	CURTIS V COOPER PRIMARY HEALTH CARE INC	Curtis V. Cooper Primary Health Care, Inc.	304 Stephenson Ave	Savannah	GA
CH04049P	Active	BPS-H80-036483	CURTIS V COOPER PRIMARY HEALTH CARE INC	Curtis V. Cooper Primary Health Care, Inc.	907 E 67th St	Savannah	GA
CH04049Q	Active	BPS-H80-037894	CURTIS V COOPER PRIMARY HEALTH CARE INC	Curtis V. Cooper Primary Health Care, Inc.	1214 N Columbia Ave	Rincon	GA
CH04049R	Active	BPS-H80-038318	CURTIS V COOPER PRIMARY HEALTH CARE INC	Curtis V. Cooper Primary Health Care, Inc.	4451 Paulsen St	Savannah	GA
CH04049S	Active	BPS-H80-039524	CURTIS V COOPER PRIMARY HEALTH CARE INC	Curtis V. Cooper Primary Health Care, Inc.	1451 GA Highway 21 S, Ste H	Springfield	GA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH04049E	ACARIAHEALTH PHARMACY, INC.	3021 SANDY PARKWAY	BLDG 2, STE A & B	COLUMBUS	GA	31909-1695	01/01/2018
CH04049D	ACARIAHEALTH PHARMACY, INC.	3021 SANDY PARKWAY	BLDG 2, STE A & B	COLUMBUS	GA	31909-1695	01/01/2018
CH040490	ALIGN INFUSION OF LOUISIANA	DBA CLINICFAST PHARMACY	2701 GENERAL DEGAULLE DR	NEW ORLEANS	LA	70114	01/01/2023
CH04049H	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2020
CH040490	AVITA PHARMACY 1040	AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10	6100 CORPORATE BLVD STE 250	BATON ROUGE	LA	70808	01/01/2020
CH040490	AVITA PHARMACY 1046	LONG'S DRUGS OF SANDERSVILLE, GEORGIA, I	2140 PEACHTREE RD NW STE 232	ATLANTA	GA	30309	07/01/2023
CH040490	CANDLER PRESCRIPTION CENTER CORP	5354 REYNOLDS STREET	SUITE 103	SAVANNAH	GA	31405	04/24/2020
CH040490	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	04/24/2020
CH04049H	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	10/01/2020
CH04049H	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/01/2020
CH04049H	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	10/01/2020
CH04049H	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/01/2020
CH04049H	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/01/2020
CH04049H	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/01/2020
CH04049H	CAREMARK PUERTO RICO SPECIALTY PHARMACY,	CAREMARK PUERTO RICO SPECIALTY PHARMACY	6020 AVE ROBERTO SANCHEZ VILELLA	CAROLINA	PR	00982	10/01/2020
CH04049H	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/01/2020
CH04049H	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/01/2020
CH04049H	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/01/2020
CH040490	COORDINATED CARE NETWORK	COORDINATED CARE NETWORK	300 PENN CENTER BLVD STE 405	PITTSBURGH	PA	15235-5511	07/01/2016	05/05/2023
CH040490	CURTIS V COOPER	CURTIS V COOPER PRIMARY HEALTHCARE, INC	2 ROBERTS ST	SAVANNAH	GA	31408	10/01/2015
CH040490	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	07/01/2024
CH040490	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	07/01/2024
CH04049H	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/01/2020
CH040490	GENOA HEALTHCARE LLC	4451 PAULSEN ST STE 100		SAVANNAH	GA	31405	07/01/2016	07/01/2016
CH040490	GENOA HEALTHCARE LLC	4451 PAULSEN ST STE 100		SAVANNAH	GA	31405	01/01/2023
CH040490	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04260	4725 WATERS AVE	SAVANNAH	GA	31404	01/01/2020
CH040490	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04187	119 BULL ST	SAVANNAH	GA	31401	01/01/2020
CH040490	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06369	5690 OGEECHEE RD.	SAVANNAH	GA	31405	01/01/2020
CH040490	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05520	5401 ABERCORN STREET	SAVANNAH	GA	31405	01/01/2020
CH040490	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04261	2055 EAST VICTORY DR	SAVANNAH	GA	31404	01/01/2020
CH040490	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04258	100 MINUS AVE.	GARDEN CITY	GA	31408	04/01/2020
CH040490	GEORGIA CVS PHARMACY, L.L.C.	CVS/PHARMACY # 11017	500 POOLER PKWY.	POOLER	GA	31322	04/01/2020
CH040490	GEORGIA CVS PHARMACY, L.L.C.	CVS PHARMACY # 17397	1907 E VICTORY DR	SAVANNAH	GA	31404	04/24/2020
CH040490	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07758	410 S. COLUMBIA AVE.	RINCON	GA	31326	04/24/2020
CH040490	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04257	712 STEPHENSON AVE.	SAVANNAH	GA	31405	04/24/2020
CH040490	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04230	150 JOHNNY MERCER BLVD	SAVANNAH	GA	31410	04/24/2020
CH04049H	GEORGIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 00060	7300 GA HIGHWAY 21	PORT WENTWORTH	GA	31407	10/01/2020
CH040490	INFINITY COMPOUNDING SOLUTIONS, LLC	DBA INFINITY CARE SOLUTIONS	1204 SE 28TH ST STE 2	BENTONVILLE	AR	72712-3887	01/01/2023
CH040490	KROGER DRUGSTORE #418	311 EAST GWINNETT STREET		SAVANNAH	GA	31401	04/24/2020
CH040490	LONG'S DEKALB HEALTH PHARMACY	AVITA PHARMACY 1045	1428 SCOTT BLVD	DECATUR	GA	30030	01/01/2020
CH040490	LONGS DRUGS OF LEXINGTON	D/B/A AVITA PHARMACY 1051	1216 W MAIN ST STE D	LEXINGTON	SC	29072-2453	01/01/2020
CH040490	META PHARMACY SAVANNAH LLC DB/A SAVANNAH	1000 EISENHOWER DR STE A		SAVANNAH	GA	31406-2601	01/01/2023
CH040490	MLK PHARMACY	SHIV PHARMACY, INC	718 MARTIN LUTHER KING BLVD SUITE A	SAVANNAH	GA	31401	07/01/2018	05/05/2023
CH040490	POLARIS PHARMACY SERVICES OF FT LAUDERDA	2900 NW 60TH ST		FT LAUDERDALE	FL	33309-1774	07/01/2024
CH04049H	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	10/01/2020
CH04049H	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	10/01/2020
CH04049H	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/01/2020
CH04049H	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/01/2020
CH040490	PUBLIX PHARMACY #0522	5500 ABERCORN STREET STE 2		SAVANNAH	GA	31405	07/01/2023
CH040490	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #0521	4717 HWY 80 E STE B	SAVANNAH	GA	31410	07/01/2023
CH040490	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #1584	101 BLUE MOON CROSSING	POOLER	GA	31322	07/01/2023
CH040490	PUBLIX SUPER MARKETS, INC.	PUBLIX CENTRAL PHARMACY #3201	2424 ORLANDO CENTRAL PARKWAY	ORLANDO	FL	32809	07/01/2023
CH040490	PUBLIX SUPER MARKETS, INC.	PUBLIX PHARMACY #3213	1950 SAND LAKE RD, BLDG #5	ORLANDO	FL	32809	07/01/2023
CH040490	QUICK RX	516 US HIGHWAY 80 W		GARDEN CITY	GA	31408-3108	07/01/2015
CH040490	QUICK RX #3	GARDEN CITY SHOPPING PLAZA	5204 AUGUSTA RD	GARDEN CITY	GA	31408	07/01/2015
CH040490	QUICK RX DRUG INC #8	1001 MEMORIAL LN		SAVANNAH	GA	31410	07/01/2015
CH040490	QUICK RX DRUGS #7	110 MEDICAL PARK DR		POOLER	GA	31322	07/01/2015
CH040490	QUICK RX DRUGS INC	504 N LAUREL ST		SPRINGFIELD	GA	31329-6814	07/01/2015
CH040490	QUICK RX DRUGS INC #4	DBA QUICK RX DRUGS #4	100 GOSHEN RD	RINCON	GA	31326	07/01/2015
CH040490	THE KROGER DRUGSTORE #979	1900 EAST VICTORY DRIVE		SAVANNAH	GA	31404	07/01/2023
CH040490	THE PRESCRIPTION SHOP	911 E 65TH ST	DBA QUICK RX DRUGS #5	SAVANNAH	GA	31405-4412	07/01/2015
CH040490	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2020
CH040490	WAL-MART PHARMACY 10-0605	1955 EAST MONTGOMERY CROSSROAD		SAVANNAH	GA	31406	04/01/2018
CH040490	WAL-MART PHARMACY 10-0606	4725 EAST HWY 80		SAVANNAH	GA	31410	04/01/2018	05/05/2023
CH040490	WAL-MART PHARMACY 10-0635	6000 OGEECHEE ROAD		SAVANNAH (S)	GA	31419	04/01/2018
CH040490	WAL-MART PHARMACY 10-1011	434 S COLUMBIA AVE		RINCON	GA	31326	07/01/2023
CH040490	WAL-MART PHARMACY 10-2860	160 POOLER PARKWAY		POOLER	GA	31322	04/01/2018
CH040490	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2020
CH040490	WALGREEN CO	DBA: WALGREENS #10799	409 S COLUMBIA AVE	RINCON	GA	31326	01/01/2024
CH040490	WALGREEN CO	DBA: WALGREENS #11538	4210 AUGUSTA RD	GARDEN CITY	GA	31408	01/01/2024
CH040490	WALGREEN CO.	DBA: WALGREENS # 02171	700 EAST DERENNE AVE	SAVANNAH	GA	31405-6716	01/01/2024
CH040490	WALGREEN CO.	DBA: WALGREENS # 05368	11509 ABERCORN ST	SAVANNAH	GA	31419	01/01/2024
CH040490	WALGREEN CO.	DBA: WALGREENS # 06098	125 JOHNNY MERCER BLVD	SAVANNAH	GA	31410	01/01/2024
CH040490	WALGREEN CO.	DBA; WALGREENS #10506	2270 US HIGHWAY 17	RICHMOND HILL	GA	31324	01/01/2024
CH040490	WALGREEN CO.	DBA: WALGREENS #10635	5701 OGEECHEE RD	SAVANNAH	GA	31405	01/01/2024
CH040490	WALGREEN CO.	COMMUNITY A WALGREENS PHARMACY #15304	1874 PIEDMONT AVE NE STE 100A	ATLANTA	GA	30324	01/01/2024
CH040490	WALGREEN CO.	DBA: WALGREENS #15611	2109 E VICTORY DRIVE	SAVANNAH	GA	31404	01/01/2024
CH040490	WALGREEN CO.	WALGREENS #18341	1038 US HIGHWAY 80 W	POOLER	GA	31322	01/01/2024
CH040490	WALGREEN CO.	WALGREENS #19629	4600 HABERSHAM ST	SAVANNAH	GA	31405	01/01/2024
CH040490	WALMART PHARMACY 10-4530	10530 ABERCORN STREET		SAVANNAH	GA	31419	07/01/2023
CH040490	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2023
CH040490	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	1/1/2025 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		6/3/2024 12:00:00 AM	11/5/2024 9:20 AM
Details	State	Update	Termination Request	Active	To Be Terminated	11/5/2024 9:20 AM
Terminations	Termination Comments	Update	Termination Request		This site's operations were relocated to 4451 Paulsen Street, Savannah, GA 31405	11/5/2024 9:20 AM
Terminations	Termination Date	Update	Termination Request		1/1/2025 12:00:00 AM	11/5/2024 9:20 AM
Terminations	Termination Effective Date	Update	Termination Request		7/1/2024 12:00:00 AM	11/5/2024 9:20 AM
Terminations	Termination Reason	Update	Termination Request		Site closure	11/5/2024 9:20 AM
Details	Last Recertification Date	Update	Recertification	2/7/2023 3:20:00 PM	2/4/2024 2:04:05 PM	2/4/2024 2:04 PM
Details	Last Recertification Date	Update	Recertification	2/8/2022 2:24:16 PM	2/7/2023 3:20:00 PM	2/7/2023 3:20 PM
Contacts	Primary Contact	Update	Profile Change Request	Daniels, Earlene J Chief Administrative Officer Curtis V. Cooper Primary Health care, Inc. 9125271088	Daniels, Earlene J Chief Financial Officer Curtis V. Cooper Primary Health care, Inc. 9125271088	10/4/2022 11:42 AM
Details	Last Recertification Date	Update	Recertification	2/9/2021 4:24:20 PM	2/8/2022 2:24:16 PM	2/8/2022 2:24 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1053675132 ( )		2/9/2021 4:24 PM
Details	Last Recertification Date	Update	Recertification	2/6/2020 8:12:33 AM	2/9/2021 4:24:20 PM	2/9/2021 4:24 PM
Contacts	Primary Contact	Update	Profile Change Request	Daniels, Earlene J CFO Curtis V. Cooper Primary Health care, Inc. 9125271088	Daniels, Earlene J Chief Administrative Officer Curtis V. Cooper Primary Health care, Inc. 9125271088	8/24/2020 12:34 PM
Details	Last Recertification Date	Update	Recertification	1/29/2019 9:04:00 AM	2/6/2020 8:12:33 AM	2/6/2020 8:12 AM
Addresses	Main Address	Update	Change Request	Domestic Violence Setting - Address Undisclosed Undisclosed, GA 00000	800 E. 70th St., Savannah, GA 31405	1/21/2020 9:09 AM
Addresses	Billing Address	Insert	Change Request		Curtis V.Cooper Primary Health Care, Inc. 106 E. Broad Street Sa, GA 31401	1/21/2020 9:09 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1053675132	1/21/2020 9:09 AM
Details	Entity Subname	Update	Change Request	Curtis V. Cooper Primary Health Care, Inc. -70th St.	Curtis V. Cooper Primary Health Care, Inc.	1/21/2020 9:09 AM
Details	Last Recertification Date	Update	Recertification	2/9/2018 3:47:41 PM	1/29/2019 9:04:00 AM	1/29/2019 9:04 AM
Details	Last Recertification Date	Update	Recertification		2/9/2018 3:47:41 PM	2/9/2018 3:47 PM
Details	State	Update		Approved	Active	1/1/2018 12:00 AM
Contacts	Signed By	Insert	New Registration		Grandy JR., Albert B. CEO Curtis V. Cooper Primary Health Care, inc. 9125271117	12/14/2017 10:49 AM
Details	340B ID	Update	New Registration		CH04049F	12/14/2017 10:49 AM
Dates	Participating Approval Date	Update	New Registration		12/14/2017 10:49:07 AM	12/14/2017 10:49 AM
Details	State	Update	New Registration	Pending	Approved	12/14/2017 10:49 AM
Dates	Signed By Date	Update	New Registration		12/14/2017 10:42:04 AM	12/14/2017 10:49 AM
Dates	Start Date	Update	New Registration		1/1/2018 12:00:00 AM	12/14/2017 10:49 AM
Addresses	Main Address	Insert	New Registration		Domestic Violence Setting - Address Undisclosed Undisclosed, GA 00000	12/14/2017 10:42 AM
Contacts	Primary Contact	Insert	New Registration		Daniels, Earlene J CFO Curtis V. Cooper Primary Health care, Inc. 9125271088	12/14/2017 10:42 AM
Contacts	Authorizing Official	Insert	New Registration		Grandy JR., Albert B. CEO Curtis V. Cooper Primary Health Care, inc. 9125271117	12/14/2017 10:42 AM
Details	Last Recertification Date	Insert	New Registration			12/14/2017 10:42 AM
Details	Grant Number	Insert	New Registration		H80CS00082	12/14/2017 10:42 AM
Details	340B ID	Insert	New Registration			12/14/2017 10:42 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			12/14/2017 10:42 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			12/14/2017 10:42 AM
Details	Medicare Provider Number	Insert	New Registration			12/14/2017 10:42 AM
Details	Entity Name	Insert	New Registration		CURTIS V COOPER PRIMARY HEALTH CARE INC	12/14/2017 10:42 AM
Details	Program Code	Insert	New Registration		CH	12/14/2017 10:42 AM
Details	Entity Subname	Insert	New Registration		Curtis V. Cooper Primary Health Care, Inc. -70th St.	12/14/2017 10:42 AM
Dates	Participating Approval Date	Insert	New Registration			12/14/2017 10:42 AM
Details	State	Insert	New Registration		Pending	12/14/2017 10:42 AM
Dates	Registration Date	Insert	New Registration		12/14/2017 10:42:01 AM	12/14/2017 10:42 AM
Dates	Signed By Date	Insert	New Registration			12/14/2017 10:42 AM
Dates	Start Date	Insert	New Registration			12/14/2017 10:42 AM
Terminations	Termination Comments	Insert	New Registration			12/14/2017 10:42 AM
Terminations	Termination Date	Insert	New Registration			12/14/2017 10:42 AM
Terminations	Termination Effective Date	Insert	New Registration			12/14/2017 10:42 AM
Terminations	Termination Reason	Insert	New Registration			12/14/2017 10:42 AM

340B Drug Pricing Program Database