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ADIRONDACK APOTHECARY
CH021790 HUDSON HEADWATERS HEALTH NETWORK
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Covered Entity Details
Entity Name
HUDSON HEADWATERS HEALTH NETWORK
Subdivision Name
Hudson Headwaters Administrative Offices
Type
HRSA-Funded Health Center
340B ID
CH021790
Entity Address
9 CAREY ROAD
QUEENSBURY, NY 12804
Grant Number
H80CS00159
Participating Start Date
4/1/2001
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
ADIRONDACK APOTHECARY
Pharmacy Address
SCHROON LAKE PHARMACY DBA
1081 MAIN STREET US RT.9
P.O. BOX 458
SCHROON LAKE, NY 12870
Pharmacy Comments
Contract Details
Approval Date
12/30/2011
Contract Begin Date
12/30/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
George Purdue, Chief Administrative Officer
(518) 761-0300 Ext: 31114
Contract Pharmacy Representative
Adirondack Apothecary
James Bowen, President
(518) 532-0005
Signed By Date
12/19/2011
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