Pharmacy Details

E R BLACK PHARMACY - information as of 5/28/2025 5:23:03 PM

Name
E R BLACK PHARMACY

Address

9553 MAIN ST.
HOLLAND PATENT, NY 13354

Comments

Contracts
History

Contracts

Contract Detail	340B ID	Entity Name	Sub Name	Entity Type	Address	Address Cont.	City	State	Begin Date	Term Date	Edit Date
Details	DSH330044	MVHS, Inc. DBA: Wynn Hospital		Disproportionate Share Hospital	111 Hospital Drive		Utica	NY	07/01/2017		5/21/2019 10:56 AM

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Pharmacy Address	Insert			E R BLACK PHARMACY 9553 MAIN ST. HOLLAND PATENT, NY 13354	9/29/2017 6:44 AM
Details	Comments	Insert				3/28/2013 4:03 PM
Details	Is Deleted	Insert			False	3/28/2013 4:03 PM
Addresses	Pharmacy Address	Insert			E R BLACK PHARMACY 9553 MAIN ST. HOLLAND PATENT, NY 13354	3/28/2013 4:03 PM
Details	Name	Insert			E R BLACK PHARMACY	3/28/2013 4:03 PM