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CH02124F FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC (Terminated)
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Main Details
Name
FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC
Subdivision Name
FAMILY HEALTH NETWORK DENTAL OFFICE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004348
340B ID
CH02124F
Grant Number
H80CS00065
Additional Details
Current Program Status
Terminated
Registration Date
12/6/2006
Participating Start Date
1/1/2007
Participating Approval Date
12/6/2006
Last Recertification Date
3/7/2016
Termination Date
Termination Reason
4/1/2016
Site closure
Contacts
Authorizing Official
Family Health Network of CNY, Inc
WALTER PRIEST, EXECUTIVE DIRECTOR
(607) 753-3797
Primary Contact
Family Health Network of CNY, Inc
AMY M. SKEELE, 340B Analyst/Credentialing Coordinator
(607) 753-3797
Addresses
Street Address
24 GROTON AVENUE
CORTLAND, NY 13045
Billing Address
FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC
17 MAIN STREET SUITE 302
CORTLAND, NY 13045
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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2/3/14 reversing address change that was done through an on-line change request 1/9/14
02/03/2014
June 2025
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