Document text
C4591001 COMPREHENSIVE LIST OF ALL CLINICAL SITES Page 1 of 9
PFIZER CONFIDENTIAL 04-Oct-2021 14:03:58 GMT
Site Identifier Investigator Name
(Prior Clinical Investigator(s)) Site Address at Time of Clinical Study
Site Contact Information at
Time of Clinical Study
1005 Matthew Davis Rochester Clinical Research, Inc.
500 Helendale Rd, Ste 265
Rochester, NEW YORK 14609
UNITED STATES
Phone: (585) -288-0890
Email: [email protected]
Fax: 5852880893
1005 Matthew Davis Rochester Clinical Research, Inc.
500 Helendale Rd, L20
Rochester, NY 14609
UNITED STATES
Phone: (585) -288-0890
Email: [email protected]
Fax: 5852880893
1006 James Peterson J. Lewis Rese arch, Inc. / Foothill Family Clinic
2295 Foothill Dr
Salt Lake City, UT 84109
UNITED STATES
Phone: 801.486.3021 ext. 3370
Email:
[email protected]
Fax:
1007 Robert Frenck Cincinnati Children's Hospital Medical Center
Cincinnati Center for Clinical Research (CCCR)
619 Oak St
Cincinnati, OH 45206
UNITED STATES
Phone: 5136364463
Email:
[email protected]
Fax: 5136367039
1007 Robert Frenck Cincinnati Children's Hospital Medical Center
Gamble Program for Clinical Studies
3333 Burnet Ave, MLC 6014
Cincinnati, OH 45229 -3039
UNITED STATES
Phone: 5136364463
Email:
[email protected]
Fax: 5136367039
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Site Identifier Investigator Name
(Prior Clinical Investigator(s)) Site Address at Time of Clinical Study
Site Contact Information at
Time of Clinical Study
1008 Timothy Jennings Clinical Research Professionals
17998 Chesterfield Airport Rd, Ste 100
Chesterfield, MO 63005
UNITED STATES
Phone: 6362201200
Email:
tjennings@clinicalresearchprofe
ssionals.net
Fax: 3146673331
1009 Shane Christensen J. Lewis Research, Inc. / Foothill Family Clinic
South
6360 S 3000 E, Ste 100
Salt Lake City, UT 84121
UNITED STATES
Phone: (801) 554 -0158
Email:
[email protected]
m
Fax: 8017337063
1013 Michael Dever Clinical Neuroscience Solutions, Inc. dba CNS
Healthcare
618 E. S St, Ste 100
Orlando, FL 32801
UNITED STATES
Phone: (407) -425-5100
Email:
[email protected]
Fax: 4074253009
1016 Daniel Finn Kentucky Pediatric/ Adult Research
201 S 5th St
Bardstown, KENTUCKY 40004
UNITED STATES
Phone: (502) -349-1569
Email:
Fax: 5023490286
1039 Gretchen Crook ARC Clinical Research at Wilson Parke
11714 Wilson Parke Ave., Ste 150
Austin, TX 78726
UNITED STATES
Phone: 737 -247-7240
Email: [email protected]
Fax: 7372477242
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Site Identifier Investigator Name
(Prior Clinical Investigator(s)) Site Address at Time of Clinical Study
Site Contact Information at
Time of Clinical Study
1044 Aaron Hartman Virginia Research Center LLC
13911 St. Francis Blvd., Ste 101
Midlothian, VA 23114
UNITED STATES
Phone: 804 -893-2273
Email:
ahartman@virginiaresearchcent
er.com
Fax: 18663724381
1057 Fadi Chalhoub Clinical Neuroscience Solutions, Inc.
5200 Belfort Rd, Ste 420
Jacksonville, FL 32256
UNITED STATES
Phone: (904) -281-5757
Email:
[email protected]
Fax:
1066 David Butuk Solaris Clinical Research
1525 E Leigh Field Dr, # 100
Meridian, ID 83646
UNITED STATES
Phone: 2082880123
Email:
[email protected]
Fax:
1077 Suchet Patel Meridian Clinical Research
415 Hooper Rd
Endwell, NEW YORK 13760
UNITED STATES
Phone: 6077544081
Email: [email protected]
Fax: 6077545730
1077 Suchet Patel Meridian Clinical Research LLC
409 Hooper Rd
Endwell, NEW YORK 13760
UNITED STATES
Phone: 6077544081
Email: [email protected]
Fax: 6077545730
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Site Identifier Investigator Name
(Prior Clinical Investigator(s)) Site Address at Time of Clinical Study
Site Contact Information at
Time of Clinical Study
1084 Douglas Denham Clinical Trials of Texas, Inc.
(Storage Only)
5430 Fredericksburg Rd., Ste 601
San Antonio, TEXAS 78229
UNITED STATES
Phone: (210) -949-0122
Email: [email protected]
Fax: 2109490181
1084 Douglas Denham Clinical Trials of Texas, Inc.
5430 Fredericksburg Rd, Ste 200
San Antonio, TEXAS 78229
UNITED STATES
Phone: (210) -949-0122
Email: [email protected]
Fax: 2109490181
1091 Samir Arora Aventiv Research Inc (Facility and Drug Shipment
Address)
99 N. Brice Rd, Ste 260
Columbus, OHIO 43213
UNITED STATES
Phone: (614) -501-6164
Email:
[email protected]
Fax: 6145016165
1091 Samir Arora Aventiv Research Inc.
99 N. Brice Rd, Ste 210
Columbus, OHIO 43213
UNITED STATES
Phone: (614) -501-6164
Email:
[email protected]
Fax: 6145016165
1123 Brandon Essink Meridian Clinical Research, LLC
3319 N 107th St.
Omaha, NEBRASKA 68134
UNITED STATES
Phone: 4029336500
Email: [email protected]
Fax: 4029336501
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Site Identifier Investigator Name
(Prior Clinical Investigator(s)) Site Address at Time of Clinical Study
Site Contact Information at
Time of Clinical Study
1124 David Fried Velocity Clinical Research, Providence
400 Bald Hill Rd
Warwick, RHODE ISLAND 02886
UNITED STATES
Phone: 4017399350
Email:
dr.fried@omegamedicalresearc
h.com
Fax: 4017399351
1125 Charles Harper Meridian Clinical Research, LLC
1410 N 13th St, Ste 5
Norfolk, NE 68701
UNITED STATES
Phone: (402) -371-0797
Email: [email protected]
Fax: 8885888068
1126 Nicola Klein Kaiser Permanente Sacramento
1650 Response Rd
Sacramento, CA 95815
UNITED STATES
Phone: 5102677540
Email: [email protected]
Fax: 5102677524
1126 Nicola Klein Kaiser Permanente Santa Clara
710 Lawrence Expy
Santa Clara, CALIFORNIA 95051
UNITED STATES
Phone: 5102677540
Email: [email protected]
Fax: 5102677524
1131 William Randall PriMED Clinical Research
948 Patterson Rd
Dayton, OHIO 45419
UNITED STATES
Phone: +1(937) -534-4201
Email:
Fax:
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Site Identifier Investigator Name
(Prior Clinical Investigator(s)) Site Address at Time of Clinical Study
Site Contact Information at
Time of Clinical Study
1139 Emmanuel Walter Accessioning Unit and Repository
2 Genome Court
Durham, NORTH CAROLINA 27710
UNITED STATES
Phone: 9196205346
Email: [email protected]
Fax: 9196131550
1139 Emmanuel Walter Clinical Research Pickett Road
3024 Pickett Rd, Durham County
Durham, NORTH CAROLINA 27705
UNITED STATES
Phone: 9196205346
Email: [email protected]
Fax: 9196131550
1139 Emmanuel Walter Duke University Medicine Circle - Duke Early Phase
Clinical Research Unit
40 Duke Medicine Circle
Durham, NC 27710
UNITED STATES
Phone: 9196205346
Email: [email protected]
Fax: 9196131550
1139 Emmanuel Walter Duke Vaccine and Trials Unit
2608 Erwin Rd, Ste 210
Durham, NORTH CAROLINA 27705
UNITED STATES
Phone: 9196205346
Email: [email protected]
Fax: 9196131550
1140 Stephen Thomas SUNY Upstate Medical University
Institute for Human Performance
505 Irving Ave, Clinical Research Unit
Syracuse, NEW YORK 13210
UNITED STATES
Phone: 3154645815
Email: [email protected]
Fax: 3154641531
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PFIZER CONFIDENTIAL 04-Oct-2021 14:03:58 GMT
Site Identifier Investigator Name
(Prior Clinical Investigator(s)) Site Address at Time of Clinical Study
Site Contact Information at
Time of Clinical Study
1140 Stephen Thomas SUNY Upstate Medical University
Medicine
4900 Broad Rd, Physician Ofc Bldg N, Ste 4U
Syracuse, NEW YORK 13215
UNITED STATES
Phone: 3154645815
Email: [email protected]
Fax: 3154641531
1142 Richard Rupp University of Texas Medical Branch
SIVS Clinical Trials Program, Primary Care
Pavilion, 400 Harborside Dr., Ste 126
Galveston, TEXAS 77555
UNITED STATES
Phone: (409) 772 -5278
Email: [email protected]
Fax: 4097725275
1147 Julia Garcia -Diaz Ochsner Clinic Foundation
1514 Jefferson Hwy
New Orleans, LA 70121
UNITED STATES
Phone: (504) 842 -7617
Email:
jgarcia [email protected]
Fax: 5047038870
1150 Shelly Senders Senders Pediatrics
2054 S Green Rd
South Euclid, OH 44121
UNITED STATES
Phone: 12162919210
Email:
[email protected]
m
Fax: 2162918688
1152 Donald Brandon California Research Foundation
4180 Ruffin Rd, Ste 255
San Diego, CALIFORNIA 92123 -1881
UNITED STATES
Phone: 619 -255-2980
Email: [email protected]
Fax:
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PFIZER CONFIDENTIAL 04-Oct-2021 14:03:58 GMT
Site Identifier Investigator Name
(Prior Clinical Investigator(s)) Site Address at Time of Clinical Study
Site Contact Information at
Time of Clinical Study
1156 Hector Rodriguez Acevedo Clinical Research Associates
2400 Nw 54th St
Miami, FL 33142
UNITED STATES
Phone: (305) 649 -8871
Email:
hrodriguez.md@acevedoclinica
lresearch.com
Fax: 3056750516
1223 Onyema Ogbuagu Yale Center for Clinical Investigations (CSRU)
2 Church St S, Ste 114
New Haven, CT 06519
UNITED STATES
Phone: 516 -281-4557, (516)
281-4557
Email:
[email protected]
Fax: 2037857450
1223 Onyema Ogbuagu Yale University
School of Medicine
135 College St, Ste 392
New Haven, CT 06510
UNITED STATES
Phone: 516 -281-4557, (516)
281-4557
Email:
[email protected]
Fax: 2037857450
1223 Onyema Ogbuagu Yale -New Haven Hospital
55 Park St, LL -15
New Haven, CT 06511
UNITED STATES
Phone: 516 -281-4557, (516)
281-4557
Email:
[email protected]
Fax: 2037857450
1235 John Vanchiere LSU Health Sciences Center at Shreveport Clinical
Trials Office
1801 Fairfield Ave, Ste 203
Shreveport, LA 71101
UNITED STATES
Phone: 3186757076
Email: [email protected]
Fax: 3186756059
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PFIZER CONFIDENTIAL 04-Oct-2021 14:03:58 GMT
Site Identifier Investigator Name
(Prior Clinical Investigator(s)) Site Address at Time of Clinical Study
Site Contact Information at
Time of Clinical Study
1235 John Vanchiere LSUHSC -Shreveport
1501 Kings Hwy
Shreveport, LA 71103
UNITED STATES
Phone: 3186757076
Email: [email protected]
Fax: 3186756059
1270 Nicola Klein Kaiser Permanente Sacramento
1650 Response Rd
Sacramento, CA 95815
UNITED STATES
Phone: (510) -267-7538
Email: [email protected]
Fax: 5102677524
1270 Nicola Klein Kaiser Permanente Santa Clara
710 Lawrence Expy
Santa Clara, CALIFORNIA 95051
UNITED STATES
Phone: (510) -267-7538
Email: [email protected]
Fax: 5102677524
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Pfizer CV for COVID
_Davis%20One%20Page%20CV%205.2020.pdf
8986d899f24dd703deb73ef98bf1a14c0bef93a0
MM / DD / YYYY
Completed
This document was requested on eregbinder.com and signed on prod.eregbinder.com
05 / 07 / 2020
10:19:33 UTC-5
Sent for signature to Matthew Davis ([email protected])from [email protected]: 24.169.90.114
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Viewed by Matthew Davis ([email protected])IP: 24.169.90.114
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10:55:12 UTC-5
Signed by Matthew Davis ([email protected])IP: 24.169.90.114
The document has been completed.
05 / 07 / 2020
10:55:12 UTC-5
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ABBREVIATED CURRICULUM VITAE TEMPLATE
TMF Doc ID
270.01, 272.01PFIZER CONFIDENTIAL
Page 1 of 1INV02-INV04-WI-GL02-SD01
Version 2.0, 16-Mar-2020 Last Name First Name Middle Name
Full Legal
Name: PatelSuchet R
Professional Mailing Address:
Street Address 1:
Meridian Clinical Research, LLC Street Address 2:
415 Hooper Road
City:
EndwellState/Province:
New York Country:
USAZip/Postal Code:
13760
Email Address: [email protected]
Academic Qualifications:
Degree and/or Certification Date (yyyy) Institution and/or Country
Bachelor of Medicine 1990 BJ Medical College, India
Bachelor of Surgery 1990 BJ Medical College, India
Medical License Number State/Province Country
217880-1 New York USA
Current Position at Study Site:
Start Date Title Institution or Company State/Province & Country
2000 Investigator Meridian Clinical Research, LLC. NY, USA
Previous Relevant Positions Including Academic Appointments:
Start and End Dates Title Institution or Company Country
2011 - Present Lab Director Endwell Family Physicians USA
2000 -Present Physician Endwell Family Physicians USA
2000 - Present Active Staff Wilson Medical Center USA
2000 to July 2019 Medical Director Regional Clinical Research,
IncUSA
1997- 2000 Family Practice Residency Guthrie Clinic, Robert
Packer HospitalUSA
1996 – 1997 Transitional Year Residency Frankford Hospital USA
Brief Summary of Relevant Clinical Research Experience:
Has conducted out-patient clinical research studies for 20 + years in collaboration with countless pharmaceutical
companies. Has been an Investigator or Sub Investigator in many trials, with a wide variety of therapeutic indications,
including: migraine, diabetes, stress incontinence, osteoarthritis, hypertension, hyperlipidemia, osteoporosis, GERD,
COPD, erectile dysfunction, smoking cessation, episodics, weight loss, vaccines, and RSV.
Signature: Signature Date: (dd-Mmm-yyyy)
I will update and resubmit my abbreviated CV if there are changes and particularly if there is any change in status which would
adversely affect the assessment of my suitability to conduct/participate in clinical studies.
NOTE: THIS CV MUST BE LIMITED TO THE INFORMATION IN THIS TEMPLATE FOR INCLUSION IN THE ICH-E3
COMPLIANT CLINICAL STUDY REPORT. ABBREVIATED CV’S CAN BE NO MORE THAN 3 PAGES, DO NOT INCLUDE
ATTACHMENTS OR TEXT ON REVERSE PAGES
.
1112650
Suchet R. Patel, MD Sponsor Current CV 26 Jun 2020 Expires 26 Jun 2022 Archived 26 Ju
n 2022
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FDA-CBER-2022-5812-0235452
This is a representation of an electronic record that was signed
electronically.
This page is the manifestation of the electronic signature(s).
Document Name: Suchet R. Patel, MD Sponsor Current CV 26 Jun 2020
Expires 26 Jun 2022 Archived 26 Jun 2022
Document ID: 1112650
Statement of Testament: I reviewed the contents of this document
Electronic Signature for: Suchet Patel
Electronically Signed by:
[email protected]
Date and Time of Signature: 29 Jun 2020 12:27 EDT
1112650
Suchet R. Patel, MD Sponsor Current CV 26 Jun 2020 Expires 26 Jun 2022 Archived 26 Ju
n 2022
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ABBREVIATED CURRICULUM VITAE TEMPLATE
TMF Doc ID
270.01, 272.01PFIZER CONFIDENTIAL
Page 1 of 1INV02-INV04-WI-GL02-SD01
Version 2.0, 16-Mar-2020 Last Name First Name Middle Name
Full Legal
Name: EssinkBrandon James
Professional Mailing Address:
Street Address 1:
3319 North 107th StreetStreet Address 2:
City:
OmahaState/Province:
NebraskaCountry:
USAZip/Postal Code:
68134
Email Address: [email protected]
Academic Qualifications:
Degree and/or Certification Date (yyyy) Institution and/or Country
Family Practice Procedural
Fellowship2004 University of Nebraska Medical Center, USA
Family Practice Residency 2003 University of Nebraska Medical Center, USA
Doctor of Medicine 2001 University of Nebraska Medical Center, USA
Bachelor of Science 1997 University of Nebraska – Lincoln, USA
Medical License Number State/Province Country
22302 Nebraska USA
74013 Georgia USA
7971 South Dakota USA
04-41270 Kansas USA
Current Position at Study Site: Principal Investigator
Start Date Title Institution or Company State/Province & Country
2003-Present Principal Investigator Meridian Clinical Research, LLC NE/USA
Previous Relevant Positions Including Academic Appointments:
Start and End Dates Title Institution or Company Country
2002-Present Sub-Investigator Meridian Clinical Research,
LLCUSA
2015-Present Physician Bryan Telemedicine USA
Brief Summary of Relevant Clinical Research Experience:
Cardiovascular (HTN) Hyperlipidemia – 15 OTC - 10
Respiratory (COPD) – 12 Restless Le gs - 4
Gastrointestinal (GERD, Constipation, Heartburn) – 15 Osteoporosis - 4
Vaccine (Adult and Pediatric) – 86 Contraception - 3
Musculoskeletal (OA, chronic pain, fibromyalgia, IBS) – 17 Genitourinary (OAB, BPH, sexual dysfunction, UTI) - 12
Dermatologic (herpes labials, psoriasis) – 15 Endocrinology (diabetes, thyroid) - 8
Migraine - 8
Signature: Signature Date: (dd-Mmm-yyyy)
I will update and resubmit my abbreviated CV if there are changes and particularly if there is any change in status which would
adversely affect the assessment of my suitability to conduct/participate in clinical studies.
NOTE: THIS CV MUST BE LIMITED TO THE INFORMATION CONTAINED IN THIS TEMPLATE FOR INCLUSION IN THE
ICH-E3 COMPLIANT CLINICAL STUDY REPORT. MULTI-PAGE CVS ARE NOT ACCEPTABLE. DO NOT INCLUDE
ATTACHMENTS, AND TEXT ON THE REVERSE SIDE.
908335
Brandon James Essink, MD Version 2.0 16 MAR 2020 Pfizer One Page Current CV 24 Apr 20
20 Expires 24 Apr 2022 Archived
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FDA-CBER-2022-5812-0235456
This is a representation of an electronic record that was signed
electronically.
This page is the manifestation of the electronic signature(s).
Document Name: Brandon James Essink, MD Version 2.0 16 MAR 2020 Pfizer
One Page Current CV 24 Apr 2020 Expires 24 Apr 2022 Archived
Document ID: 908335
Statement of Testament: I reviewed the contents of this document
Electronic Signature for: Brandon Essink
Electronically Signed by:
[email protected]
Date and Time of Signature: 24 Apr 2020 15:55 CDT
908335
Brandon James Essink, MD Version 2.0 16 MAR 2020 Pfizer One Page Current CV 24 Apr 20
20 Expires 24 Apr 2022 Archived
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FDA-CBER-2022-5812-0235459
This is a representation of an electronic record that was signed
electronically.
This page is the manifestation of the electronic signature(s).
Document Name: Charles Harold Harper, MD Pfizer One Page Current CV 22
Jan 2019 Expires 01 Jan 2021 Archived 01 Jan 2021
Document ID: 196341
Statement of Testament: I approved the contents of this document
Electronic Signature for: Charles Harper
Electronically Signed by:
[email protected]
Date and Time of Signature: 23 Jan 2019 10:27 CST
196341
Charles Harold Harper, MD Pfizer One Page Current CV 22 Jan 2019 Expires 01 Jan 2021
Archived 01 Jan 2021
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