Contract Pharmacy Details

WATER STREET PHARMACY, INC.
CH028210 FINGER LAKES MIGRANT HEALTH CARE PROJECT, INC.

Covered Entity Details

Entity Name

FINGER LAKES MIGRANT HEALTH CARE PROJECT, INC.

Subdivision Name

Type

HRSA-Funded Health Center

340B ID

CH028210

Entity Address

14 Maiden Lane
PENN YAN, NY 14527

Grant Number

H80CS00849

Participating Start Date

7/1/2003

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WATER STREET PHARMACY, INC.

Pharmacy Address

DBA VILLAGE DRUG
126 MAIN ST
PENN YAN, NY 14527

Pharmacy Comments

Contract Details

Approval Date

4/15/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/15/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Mary A Zelazny, CEO
(315) 531-9102

Contract Pharmacy Representative

Water Street Pharmacy Inc.
Tracey Knapp, Owner
(607) 243-8114

Signed By Date

4/15/2016

340B Drug Pricing Program Database