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NOBLE HEALTH SERVICES INC.
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
NOBLE HEALTH SERVICES INC.
Pharmacy Address
6040 TARBELL ROAD
SYRACUSE, NY 13206
Pharmacy Comments
Contract Details
Approval Date
10/1/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James T Donnelly, EVP of 340B Pharmacy Services
(518) 824-2340
Contract Pharmacy Representative
Debbi Barber, Director of PBM Relations
(315) 287-3600 Ext: 2423
Signed By Date
10/1/2015
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