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CHC26593-00 GOOD SAMARITAN HEALTH CENTER OF COBB, INC. (Active)
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Main Details
Name
GOOD SAMARITAN HEALTH CENTER OF COBB, INC.
Subdivision Name
Good Samaritan Health Center of Cobb
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013126
340B ID
CHC26593-00
Grant Number
H80CS26593
Additional Details
Current Program Status
Active
Registration Date
7/1/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/20/2015
Last Recertification Date
3/10/2025
Contacts
Authorizing Official
Good Samaritan Health Center of Cobb
Gayle Nelson, CEO
(770) 419-3120 Ext: 130
Primary Contact
Good Samaritan Health Center of Cobb
Lori Beth Stephenson, Pharmacist
(770) 419-3120
Addresses
Street Address
1605 Roberta Dr SW
Marietta, GA 30008-3855
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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7/20/15 participating 4/1/14 thru 3/31/15, not participating 4/1/15 thru 10/1/15 (internal business decision), reinstated based on on-line registration submitted in July 2015
07/20/2015
April 2025
April 2025
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