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KPH HEALTHCARE SERVICES, INC.
CH02179V HUDSON HEADWATERS HEALTH NETWORK
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Covered Entity Details
Entity Name
HUDSON HEADWATERS HEALTH NETWORK
Subdivision Name
Plattsburgh Family Health
Type
HRSA-Funded Health Center
340B ID
CH02179V
Entity Address
87 Plaza Blvd
Plattsburgh, NY 12901-6438
Grant Number
H80CS00159
Participating Start Date
4/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
KPH HEALTHCARE SERVICES, INC.
Pharmacy Address
KINNEY DRUGS #40
6 VETERANS LANE
PLATTSBURGH, NY 12901
Pharmacy Comments
Contract Details
Approval Date
1/12/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher Tournier, CFO
(518) 761-0300 Ext: 31558
Contract Pharmacy Representative
KPH Healthcare Services, Inc.
Debbi Barber, 340B Program Director
(315) 287-3600 Ext: 2423
Signed By Date
1/12/2023
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