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CH02179L HUDSON HEADWATERS HEALTH NETWORK (Active)
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Main Details
Name
HUDSON HEADWATERS HEALTH NETWORK
Subdivision Name
Hudson Headwaters Pediatric and Adolescent Health
Type
HRSA-Funded Health Center
Site ID
BPS-H80-027828
340B ID
CH02179L
Grant Number
H80CS00159
Additional Details
Current Program Status
Active
Registration Date
4/1/2001
Participating Start Date
4/1/2001
Participating Approval Date
4/20/2004
Last Recertification Date
2/10/2025
Contacts
Authorizing Official
Hudson Headwaters Health Network
Laura Pasco, EVP, Chief Financial Officer
(518) 761-0300 Ext: 31553
Primary Contact
Hudson Headwaters Health Network
Katelyn Keys, Director of 340B Compliance
(518) 761-0300 Ext: 31324
Addresses
Street Address
28 S Western Ave
QUEENSBURY, NY 12804-3323
Billing Address
HUDSON HEADWATERS HEALTH NETWORK
9 CAREY ROAD
QUEENSBURY, NY 12804
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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4/3/12 - Changed AO ext from 114 and Contact ext from 221. 7/22/09 UPDATED BILLING ADDR (WAS 1 BROAD STREET PLAZA P.O. BOX 357 GLENS FALLS NY 12801); 5/2/08 ADDED BILL TO ADDR
04/03/2012
7/22/09 UPDATED BILLING ADDR (WAS 1 BROAD STREET PLAZA P.O. BOX 357 GLENS FALLS NY 12801); 5/2/08 ADDED BILL TO ADDR
07/22/2009
April 2025
April 2025
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