340B Drug Pricing Program Database


CH02011L WHITNEY M. YOUNG, JR., HEALTH CENTER, INC. (Active) - information as of 5/30/2025 6:49:25 PM

Main Details
WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.
WHITNEY M YOUNG JR Health Center
HRSA-Funded Health Center
BPS-H80-004577
CH02011L
H80CS00433


Additional Details
Active
1/9/2019
4/1/2019
1/28/2019
2/14/2025

Contacts

Whitney M. Young, Jr. Health Center, Inc.
David Harold Shippee, President & CEO
(518) 591-4459

Whitney M Young Jr Health Center
John E Fraher, CFO
(518) 591-4461

Addresses

900 LARK DR
ALBANY, NY 12207-1300

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Same as Street Address
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH020110ActiveBPS-H80-003829WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.WHITNEY M. YOUNG, JR. HEALTH CENTER920 Lark Dr AlbanyNY
CH02011CActiveBPS-H80-005473WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.WHITNEY M YOUNG JR MMTP10 De Witt St AlbanyNY
CH02011DActiveBPS-H80-027720WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.North Troy849 2nd Avenue TroyNY
CH02011EActiveBPS-H80-002090WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.GIFFEN MEMORIAL SCHOOL274 S Pearl St AlbanyNY
CH02011FActiveBPS-H80-002549WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.SHERIDAN PREPARATORY ACADEMY400 Sheridan Ave AlbanyNY
CH02011GActiveBPS-H80-004852WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.PHILLP SCHUYLER ACHIEVEMENT676 CLINTON AVE ALBANYNY
CH02011HActiveBPS-H80-017792WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.Watervliet Health Center1804 2nd Avenue WatervlietNY
CH02011JActiveBPS-H80-024758WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.Watervliet Junior-Senior High School1245 Hillside Dr WatervlietNY
CH02011KActiveBPS-H80-014500WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.WYH Mobile Heatlh Unit -WOW900 Lark Drive AlbanyNY
CH02011LActiveBPS-H80-004577WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.WHITNEY M YOUNG JR Health Center900 LARK DR ALBANYNY
CH02011MActiveBPS-H80-031465WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.Albany High School700 Washington Ave AlbanyNY
CH02011NActiveBPS-H80-034219WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.Swinburne Health Center526 Central Avenue STE 101 AlbanyNY
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH020110ALBANY COLLEGE OF PHARMACY AND HEALTH SCDBA: COLLEGE PARKSIDE PHARMACY 920 LARK DR
ALBANYNY12207-160307/01/2019  
CH020110CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361410/01/2019  
CH020110CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005610/01/2019  
CH020110CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621910/01/2019  
CH020110CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175710/01/2019  
CH020110CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808310/01/2019  
CH020110CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700410/01/2019  
CH020110CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761710/01/2019  
CH020110CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813310/01/2019  
CH020110CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237410/01/2019  
CH020110CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911904/01/2022  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00680 153 CENTRAL AVENUE
ALBANYNY1220601/01/2017 07/18/2023
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00344 49 FOURTH STREET
TROYNY1218001/01/2017 07/18/2024
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00375 260 DELAWARE AVENUE
DELMARNY1205401/01/2017  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00600 415-419 DELAWARE AVENUE
ALBANYNY1220901/01/2017  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00906 461 2ND AVE.
TROYNY1218201/01/2017  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00134 16 NEW SCOTLAND AVE.
ALBANYNY1220801/01/2017  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00417 885 CENTRAL AVE.
ALBANYNY1220607/01/2019  
CH020110CVS ALBANY, L.L.C.DBA CVS/PHARMACY # 724 560 N. GREENBUSH RD.
RENSSELAERNY1214407/01/2019  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00451 415 STATE ST, WALLACE BLDG
SCHENECTADYNY1230507/01/2019  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00996 1544 CRESCENT ROAD
CLIFTON PARKNY1206507/01/2019  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 01895 2040 WESTERN AVENUE, ROUTE 155
ALBANYNY1220307/01/2019  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 02137 74 MAIN AVENUE
WYNANTSKILLNY1219807/01/2019  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 02226 12 SOUTH CENTRAL AVENUE
MECHANICVILLENY1211807/01/2019  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 02340 2037 STATE STREET
SCHENECTADYNY1230407/01/2019  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 02743 485 COLUMBIA ST.
COHOESNY1204707/01/2019  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 04610 2801 GUILDERLAND AVE
ROTTERDAMNY1230607/01/2019  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 05035 1204 EASTERN AVE
SCHENECTADYNY1230807/01/2019  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 05045 1630 CHRISLER AVENUE
SCHENECTADYNY1230307/01/2019  
CH020110CVS ALBANY, L.L.C.DBA CVS/PHARMACY # 7326 726 EAST MAIN STREET
COBLESKILLNY1204307/01/2019  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00413 1026 MADISON AVENUE
ALBANYNY1220801/01/2020 09/26/2023
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00415 750 NEW LOUDON RD.
LATHAMNY1211001/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00458 50 PENNSYLVANIA AVENUE
BINGHAMTONNY1390301/01/2020 07/18/2024
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00744 613 NEW SCOTLAND AVENUE
ALBANYNY1220801/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 05031 598 COLUMBIA TURNPIKE
EAST GREENBUSHNY1206101/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 02702 465 SAND CREEK RD.
COLONIENY1220501/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 05032 541 PAWLLING AVE.
PAWLING S/C 		TROYNY1218001/01/2020 07/18/2023
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 05037 2480 US ROUTE 9W STE. 3
FAITH PLAZA 		RAVENANY1214301/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 05046 839 RTE 146
CLIFTON PARKNY1206501/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 05047 584 NEW LOUDON ROAD
LATHAMNY1211001/01/2020  
CH020110CVS ALBANY, L.L.C.CVS/PHARMACY # 16919 625 3RD AVE EXT
RENSSELAERNY1214401/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00778 1170 WESTERN AVENUE
ALBANYNY1220307/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00783 2982 ROUTE 9
VALATIENY1218407/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 01090 416 ROUTE 9W
GLENMONTNY1207707/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 05385 241 MOHAWK AVE
SCOTIANY1230207/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 05456 2027 DOUBLEDAY AVE.
BALLSTON SPANY1202007/01/2020  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 03379 653 RTE. 9
WILTONNY1283104/01/2022  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00731 34 CONGRESS ST.
SARATOGA SPRINGSNY1286604/01/2022  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00793 1013 STATE HIGHWAY 29A
GLOVERSVILLENY1207805/05/2022  
CH020110CVS ALBANY, L.L.C.CVS PHARMACY # 17514 100 AMSTERDAM COMMONS
AMSTERDAMNY1201005/05/2022  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 05389 2535 STATE ROUTE 9
MALTANY1202005/05/2022  
CH020110CVS ALBANY, L.L.C.DBA: CVS/PHARMACY # 00419 216 QUAKER ROAD
QUEENSBURYNY1280405/05/2022  
CH020110CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870605/05/2022  
CH020110CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005605/05/2022  
CH020110CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502804/01/2022  
CH020110ECKERD CORPORATIONRITE AID #10690 1901 2ND AVENUE
WATERVLIETNY1218901/01/2017 02/06/2018
CH020110ECKERD CORPORATIONRITE AID #10695 463 ALBANY SHAKER ROAD
LOUDONVILLENY1221101/01/2017 02/06/2018
CH020110FORTEEN STAR ENTERPRISES INCD/B/A CENTRAL AVE PHARMACY 65 CENTRAL AVE
ALBANYNY12206-305401/01/2021 07/22/2024
CH020110HOUSE CALLS PHARMACY #211920 LARK DRIVE
ALBANYNY1220711/08/2005 06/30/2019
CH020110LINDSAY DRUG CO INC416 5TH AVE
TROYNY12182-300701/01/2021  
CH020110MARRA'S PHARMA CORPMARRA'S PHARMACY 217 REMSEN ST
COHOESNY1204707/01/2021 09/29/2021
CH020110MARRA'S PHARMACY217 REMSEN ST
COHOESNY12047-302410/01/2021  
CH020110MARTIN'S FOODS OF SOUTH BURLINGTON, LLCDBA HANNAFORD SUPERMARKET & PHARMACY#836 900 CENTRAL AVENUE
ALBANYNY1220605/05/2022  
CH020110OPTUM PHARMACY 700, LLC19 CHAPIN RD BLDG D, STE D8
PINE BROOKNJ0705810/01/2024  
CH020110OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713010/01/2024  
CH020110OPTUM PHARMACY 706, INC.30-30 47TH AVENUE SUITE 410
LONG ISLAND CITYNY1110110/01/2024  
CH020110PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514610/01/2019  
CH020110PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920304/01/2022  
CH020110PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523304/01/2022  
CH020110RITE AID OF NEW YORK, INC.RITE AID #1031 581 CENTRAL AVENUE
ALBANYNY1220610/27/2012 03/20/2018
CH020110RITE AID OF NEW YORK, INC.RITE AID #3334 310 SOUTH PEARL STREET
ALBANYNY1220210/27/2012 03/20/2018
CH020110RITE AID OF NEW YORK, INC.RITE AID #537 17-21 NORTH PEARL STREET
ALBANYNY1220710/27/2012 03/20/2018
CH020110TOWN TOTAL HEALTH, LLC728 MADISON AVE. SUITE B1
ALBANYNY12208-330207/01/2020  
CH020110WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738604/01/2020  
CH020110WAL-MART PHARMACY 10-1806329 SOUTH KINGSBORO AVE.
GLOVERSVILLENY1207807/01/2022  
CH020110WAL-MART PHARMACY 10-1926341 ROUTE 104 EAST
OSWEGONY1312607/01/2022  
CH020110WAL-MART PHARMACY 10-1940279 TROY RD
RENSSELAERNY1214404/01/2020 09/11/2020
CH020110WAL-MART PHARMACY 10-1940279 TROY RD
RENSSELAERNY1214407/01/2022  
CH020110WAL-MART PHARMACY 10-1997800 LOUDON ROAD
LATHAMNY1211007/01/2022  
CH020110WAL-MART PHARMACY 10-2097C/O PHARMACY DEPARTMENT 460 FAIRVIEW AVE
HUDSONNY1253407/01/2022  
CH020110WAL-MART PHARMACY 10-2135139 MERCHANT PLACE
COBLESKILLNY1204307/01/2022  
CH020110WAL-MART PHARMACY 10-2152141 WASHINGTON AVENUE EXTENSION
ALBANYNY1220504/01/2020  
CH020110WAL-MART PHARMACY 10-22641320 ALTAMONT AVE
SCHENECTADYNY1230307/01/2022  
CH020110WAL-MART PHARMACY 10-2370760 HOOSICK RD
TROYNY1218004/01/2020  
CH020110WAL-MART PHARMACY 10-3583311 ROUTE 9W
GLENMONTNY1207704/01/2020  
CH020110WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283704/01/2020  
CH020110WALGREEN EASTERN CO INCDBA: WALGREENS #10548 549 HOOSICK ST.
TROYNY12180-210501/23/2012  
CH020110WALGREEN EASTERN CO., INCDBA: WALGREENS #19948 1901 2ND AVE.
WATERVLIETNY12189-221102/20/2018  
CH020110WALGREEN EASTERN CO., INCWALGREENS # 19535 305 COLUMBIA ST.
RENSSELAERNY12144-292007/01/2019  
CH020110WALGREEN EASTERN CO., INCWALGREENS #19635 869 SECOND AVE.
TROYNY12182-192007/01/2019  
CH020110WALGREEN EASTERN CO., INC.WALGREENS 41 HOLLAND AVE.
ALBANYNY1220801/23/2012  
CH020110WALGREEN EASTERN CO., INC.WALGREENS # 19884 463 ALBANY SHAKER RD
LOUDONVILLENY12211-183302/20/2018  
CH020110WALGREEN EASTERN CO., INC.WALGREENS #19988 17 N PEARL ST
ALBANYNY1220703/21/2018 04/08/2021
CH020110WALGREEN EASTERN CO., INC.RITE AID #03334 310 S PEARL ST
ALBANYNY1220203/21/2018 10/01/2018
CH020110WALGREEN EASTERN CO., INC.WALGREENS #18158 581 CENTRAL AVE
ALBANYNY1220603/21/2018 06/09/2020
CH020110WALGREEN EASTERN CO., INC.DBA: WALGREENS # 09153 2061 WESTERN AVE
GUILDERLANDNY12084-955904/01/2019  
CH020110WALGREEN EASTERN CO., INC.DBA WALGREENS SPECIALTY PHARMACY #21158 33 NEW SCOTLAND AVE STE 106
ALBANYNY1220804/01/2019  
CH020110WALGREEN EASTERN CO., INC.WALGREENS #17434 614 COLUMBIA TPKE
EAST GREENBUSHNY12061-161007/01/2019  
CH020110WALGREEN EASTERN CO., INC.WALGREENS #18141 444 BROADWAY STE 1
MENANDSNY12204-285207/01/2019 04/08/2021
CH020110WALGREEN EASTERN CO., INC.RITE AID #03331 308 ONTARIO ST
COHOESNY1204707/01/2019 05/21/2019
CH020110WALGREEN EASTERN CO., INC.WALGREENS #19787 933 LOUDON RD
LATHAMNY12110-211907/01/2019  
CH020110WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275601/01/2024  
CH020110Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
CH020110WATERVLIET PHARMACY ACQUISITION, LLCD/B/A CONNECTRX HOMETOWN 601 19TH ST
WATERVLIETNY1218910/01/2021  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/1/2024 11:37:03 AM2/14/2025 11:23:45 AM2/14/2025 11:23 AM
DetailsLast Recertification DateUpdateRecertification2/1/2023 1:54:00 PM2/1/2024 11:37:03 AM2/1/2024 11:37 AM
DetailsLast Recertification DateUpdateRecertification2/7/2022 10:25:50 AM2/1/2023 1:54:00 PM2/1/2023 1:54 PM
DetailsLast Recertification DateUpdateRecertification2/3/2021 12:42:20 PM2/7/2022 10:25:50 AM2/7/2022 10:25 AM
DetailsLast Recertification DateUpdateRecertification2/3/2020 7:14:24 PM2/3/2021 12:42:20 PM2/3/2021 12:42 PM
DetailsLast Recertification DateUpdateRecertification 2/3/2020 7:14:24 PM2/3/2020 7:14 PM
ContactsAuthorizing OfficialUpdateAO Change RequestShippee, David H. President & CEO Whitney M. Young, Jr. Health Center, Inc. 5185914459Shippee, David Harold President & CEO Whitney M. Young, Jr. Health Center, Inc. 51859144591/17/2020 8:03 AM
DetailsStateUpdate ApprovedActive4/1/2019 12:05 AM
ContactsSigned ByInsertNew Registration Shippee, David H. President & CEO Whitney M. Young, Jr. Health Center, Inc. 51859144591/28/2019 8:20 AM
Details340B IDUpdateNew Registration CH02011L1/28/2019 8:20 AM
DatesParticipating Approval DateUpdateNew Registration 1/28/2019 8:20:43 AM1/28/2019 8:20 AM
DetailsStateUpdateNew RegistrationPendingApproved1/28/2019 8:20 AM
DatesSigned By DateUpdateNew Registration 1/9/2019 9:14:42 AM1/28/2019 8:20 AM
DatesStart DateUpdateNew Registration 4/1/2019 12:00:00 AM1/28/2019 8:20 AM
ContactsPrimary ContactUpdate Fraher, John CFO Whitney M Young Jr Health Center 5185914461Fraher, John E CFO Whitney M Young Jr Health Center 51859144611/25/2019 11:28 AM
AddressesMain AddressInsertNew Registration  900 LARK DR ALBANY, NY 12207-13001/9/2019 9:14 AM
ContactsPrimary ContactInsertNew Registration Fraher, John CFO Whitney M Young Jr Health Center 51859144611/9/2019 9:14 AM
ContactsAuthorizing OfficialInsertNew Registration Shippee, David H. President & CEO Whitney M. Young, Jr. Health Center, Inc. 51859144591/9/2019 9:14 AM
DetailsLast Recertification DateInsertNew Registration  1/9/2019 9:14 AM
DetailsGrant NumberInsertNew Registration H80CS004331/9/2019 9:14 AM
Details340B IDInsertNew Registration  1/9/2019 9:14 AM
DetailsIs Authorizing Official EHB DataInsertNew Registration  1/9/2019 9:14 AM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  1/9/2019 9:14 AM
DetailsMedicare Provider NumberInsertNew Registration  1/9/2019 9:14 AM
DetailsEntity NameInsertNew Registration WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.1/9/2019 9:14 AM
DetailsProgram CodeInsertNew Registration CH1/9/2019 9:14 AM
DetailsEntity SubnameInsertNew Registration WHITNEY M YOUNG JR Health Center1/9/2019 9:14 AM
DatesParticipating Approval DateInsertNew Registration  1/9/2019 9:14 AM
DetailsStateInsertNew Registration Pending1/9/2019 9:14 AM
DatesRegistration DateInsertNew Registration 1/9/2019 9:14:39 AM1/9/2019 9:14 AM
DatesSigned By DateInsertNew Registration  1/9/2019 9:14 AM
DatesStart DateInsertNew Registration  1/9/2019 9:14 AM
TerminationsTermination CommentsInsertNew Registration  1/9/2019 9:14 AM
TerminationsTermination DateInsertNew Registration  1/9/2019 9:14 AM
TerminationsTermination Effective DateInsertNew Registration  1/9/2019 9:14 AM
TerminationsTermination ReasonInsertNew Registration  1/9/2019 9:14 AM