| Details | Last Recertification Date | Update | Recertification | 2/4/2024 6:53:04 PM | 2/11/2025 10:03:24 AM | 2/11/2025 10:03 AM |
| Contacts | Primary Contact | Update | Profile Change Request | Whitmarsh, Joshua R
Director of QA & Corporate Compliance
United Cerebral Palsy Association of the North Country
3153798339 | Whitmarsh, Joshua R
Chief Compliance Officer & COO of OPWDD Operations
United Cerebral Palsy Association of the North Country
3153798339 | 7/9/2024 7:11 AM |
| Contacts | Primary Contact | Update | PC Change Request | Mahaffy, Pamela
CFO
UCPA of the North Country, Inc. dba Community Health Center of the North Country
3153798320 | Whitmarsh, Joshua R
Director of QA & Corporate Compliance
United Cerebral Palsy Association of the North Country
3153798339 | 4/1/2024 12:15 PM |
| Contacts | Authorizing Official | Update | AO Change Request | Whitmarsh, Joshua R
Director of QA & Corporate Compliance
United Cerebral Palsy Association of the North Country
3153798339 | Bender, David
CEO
United Cerebral Palsy Association of the North Country, Inc.
3153798310 | 3/25/2024 9:45 AM |
| Contacts | Authorizing Official | Update | AO Change Request | Richey, Anne F.
CEO
UCPA of the North Country, Inc. dba Community Health Center of the North Country
3153798310 | Whitmarsh, Joshua R
Director of QA & Corporate Compliance
United Cerebral Palsy Association of the North Country
3153798339 | 3/21/2024 11:54 AM |
| Details | Last Recertification Date | Update | Recertification | 2/13/2023 9:26:37 AM | 2/4/2024 6:53:04 PM | 2/4/2024 6:53 PM |
| Details | Last Recertification Date | Update | Recertification | 2/7/2022 11:47:54 AM | 2/13/2023 9:26:37 AM | 2/13/2023 9:26 AM |
| Contacts | Primary Contact | Update | Profile Change Request | Mahaffy, Pamela
CFO
UCPA of the North Country, Inc. dba Community Health Center of the North Country
3153861156 | Mahaffy, Pamela
CFO
UCPA of the North Country, Inc. dba Community Health Center of the North Country
3153798320 | 2/2/2023 3:18 PM |
| Contacts | Authorizing Official | Update | Profile Change Request | Richey, Anne F.
Executive Director
UCPA of the North Country, Inc. dba Community Health Center of the North Country
3153798310 | Richey, Anne F.
CEO
UCPA of the North Country, Inc. dba Community Health Center of the North Country
3153798310 | 2/8/2022 8:34 AM |
| Contacts | Signed By | Update | Profile Change Request | Richey, Anne F.
Executive Director
UCPA of the North Country, Inc. dba Community Health Center of the North Country
3153798310 | Richey, Anne F.
CEO
UCPA of the North Country, Inc. dba Community Health Center of the North Country
3153798310 | 2/8/2022 8:34 AM |
| Details | Last Recertification Date | Update | Recertification | 2/1/2021 5:27:40 PM | 2/7/2022 11:47:54 AM | 2/7/2022 11:47 AM |
| Details | Last Recertification Date | Update | Recertification | | 2/1/2021 5:27:40 PM | 2/1/2021 5:27 PM |
| Details | State | Update | | Approved | Active | 4/1/2020 12:05 AM |
| Contacts | Signed By | Insert | New Registration | | Richey, Anne F.
Executive Director
UCPA of the North Country, Inc. dba Community Health Center of the North Country
3153798310 | 2/28/2020 5:09 PM |
| Details | 340B ID | Update | New Registration | | CHC08746-03 | 2/28/2020 5:09 PM |
| Dates | Participating Approval Date | Update | New Registration | | 2/28/2020 5:09:07 PM | 2/28/2020 5:09 PM |
| Details | State | Update | New Registration | Pending | Approved | 2/28/2020 5:09 PM |
| Dates | Signed By Date | Update | New Registration | | 1/7/2020 5:50:55 PM | 2/28/2020 5:09 PM |
| Dates | Start Date | Update | New Registration | | 4/1/2020 12:00:00 AM | 2/28/2020 5:09 PM |
| Addresses | Main Address | Insert | New Registration | |
102 Ford Street
Ogdensburg, NY 13669-1402 | 1/7/2020 5:50 PM |
| Addresses | Billing Address | Insert | New Registration | | Cerebral Palsy Association of the North Country
4 Commerce Lane
Canton, NY 13617 | 1/7/2020 5:50 PM |
| Contacts | Authorizing Official | Insert | New Registration | | Richey, Anne F.
Executive Director
UCPA of the North Country, Inc. dba Community Health Center of the North Country
3153798310 | 1/7/2020 5:50 PM |
| Contacts | Primary Contact | Insert | New Registration | | Mahaffy, Pamela
CFO
UCPA of the North Country, Inc. dba Community Health Center of the North Country
3153861156 | 1/7/2020 5:50 PM |
| Details | Last Recertification Date | Insert | New Registration | | | 1/7/2020 5:50 PM |
| Details | Grant Number | Insert | New Registration | | H80CS08746 | 1/7/2020 5:50 PM |
| Details | 340B ID | Insert | New Registration | | | 1/7/2020 5:50 PM |
| Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 1/7/2020 5:50 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 1/7/2020 5:50 PM |
| Details | Medicare Provider Number | Insert | New Registration | | | 1/7/2020 5:50 PM |
| Details | Entity Name | Insert | New Registration | | UNITED CEREBRAL PALSY ASSOCIATION OF THE NORTH COUNTRY, INC. | 1/7/2020 5:50 PM |
| Details | Program Code | Insert | New Registration | | CH | 1/7/2020 5:50 PM |
| Details | Entity Subname | Insert | New Registration | | Community Health Center of the North Country | 1/7/2020 5:50 PM |
| Dates | Participating Approval Date | Insert | New Registration | | | 1/7/2020 5:50 PM |
| Details | State | Insert | New Registration | | Pending | 1/7/2020 5:50 PM |
| Dates | Registration Date | Insert | New Registration | | 1/7/2020 5:50:53 PM | 1/7/2020 5:50 PM |
| Dates | Signed By Date | Insert | New Registration | | | 1/7/2020 5:50 PM |
| Dates | Start Date | Insert | New Registration | | | 1/7/2020 5:50 PM |
| Terminations | Termination Comments | Insert | New Registration | | | 1/7/2020 5:50 PM |
| Terminations | Termination Date | Insert | New Registration | | | 1/7/2020 5:50 PM |
| Terminations | Termination Effective Date | Insert | New Registration | | | 1/7/2020 5:50 PM |
| Terminations | Termination Reason | Insert | New Registration | | | 1/7/2020 5:50 PM |