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MAXOR SPECIALTY PHARMACY
CH02151C Sun River Health, Inc.
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Covered Entity Details
Entity Name
Sun River Health, Inc.
Subdivision Name
Sun River Health Walden
Type
HRSA-Funded Health Center
340B ID
CH02151C
Entity Address
75 Orange Ave
Walden, NY 12586-1816
Grant Number
H80CS00313
Participating Start Date
7/1/2003
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
MAXOR SPECIALTY PHARMACY
Pharmacy Address
216 S POLK ST
AMARILLO, TX 79101-1407
Pharmacy Comments
Contract Details
Approval Date
11/9/2012
Contract Begin Date
10/27/2012
Carve-In Effective Date
Contract Comments
11/07/2012 - public health emergency declared in the state of NY effective 10/27/2012
Contract Termination Date
Termination Reason
4/11/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Sinkoff, Executive VP & CFO
(914) 734-8722
Contract Pharmacy Representative
Jan Robinson, Vice President of Operations, Maxor Specialty and IV Solutions
(806) 324-5461
Signed By Date
10/1/2012
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