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KPH HEALTHCARE SERVICES, INC.
CAH331314-00 SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES COUNTY
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Covered Entity Details
Entity Name
SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES COUNTY
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH331314-00
Entity Address
418 NORTH MAIN STREET
PENN YAN, NY 14527
Medicare Provider Number
331314
Participating Start Date
1/1/2020
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
KPH HEALTHCARE SERVICES, INC.
Pharmacy Address
KINNEY DRUGS #111
7115 NORTH MAIN STREET
P.O. BOX 369
OVID, NY 14521
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Frank Michael Korich, Chief Operating Officer
(315) 787-4021
Contract Pharmacy Representative
KPH Healthcare Services, Inc.
Debbi Barber, 340B Program Director
(315) 287-3600 Ext: 2423
Signed By Date
1/15/2021
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