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ADIRONDACK APOTHECARY LLC
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 LLC
Pharmacy Address
D B A MORIAH PHARMACY
4315 MAIN ST
PORT HENRY, NY 12974-1339
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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