340B Drug Pricing Program Database

Pharmacy Name

ELLICOTTVILLE PHARMACY INC

Pharmacy Address

6133 ROUTE 219 S STE 1004
ELLICOTTVILLE, NY 14731-9613

Pharmacy Comments

Approval Date

8/15/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/18/2021
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Richard G. Braun Jr., SVP Finance and CFO
(716) 375-6190

Contract Pharmacy Representative

Ellicottville Pharmacy
Stephen Ward, Owner
(716) 699-2300

Signed By Date

7/11/2019