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GOODSON DRUG CO
CH047430 GEORGIA HIGHLANDS MEDICAL SERVICES, INC.
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Covered Entity Details
Entity Name
GEORGIA HIGHLANDS MEDICAL SERVICES, INC.
Subdivision Name
GHMS Cumming Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH047430
Entity Address
260 Elm St
Cumming, GA 30040-2467
Grant Number
H80CS00470
Participating Start Date
1/1/2005
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
GOODSON DRUG CO
Pharmacy Address
116 MAPLE ST
CUMMING, GA 30040
Pharmacy Comments
Contract Details
Approval Date
4/5/2005
Contract Begin Date
4/5/2005
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/18/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
CARLOS STAPLETON, CEO
(770) 887-1668 Ext: 1102
Contract Pharmacy Representative
JIMMY GOODSON, OWNER
(770) 887-5040
Signed By Date
2/15/2005
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