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ADIRONDACK APOTHECARY, LLC
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
ADIRONDACK APOTHECARY, LLC
Pharmacy Address
DBA: WILLSBORO PHARMACY
3932 NYS RT22
WILLSBORO, NY 12996
Pharmacy Comments
Contract Details
Approval Date
4/7/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Christopher Tournier, CFO
(518) 761-0300 Ext: 31558
Contract Pharmacy Representative
Adirondack Apothecary
James Bowen, President
(518) 532-0005
Signed By Date
4/7/2021
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