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KPH HEALTHCARE SERVICES, INC.
CH02124K FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC
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Covered Entity Details
Entity Name
FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC
Subdivision Name
SBHC-DERUYTER CENTRAL SCHOOL
Type
HRSA-Funded Health Center
340B ID
CH02124K
Entity Address
711 RAILROAD STREET
DERUYTER, NY 13052
Grant Number
H80CS00065
Participating Start Date
1/1/2007
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
KPH HEALTHCARE SERVICES, INC.
Pharmacy Address
KINNEY DRUGS #36
14 CLINTON AVENUE
CORTLAND, NY 13045-2197
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kimberly Marie Osborne, Chief Executive Officer
(607) 753-3797
Contract Pharmacy Representative
KPH Healthcare Services, Inc.
Debbi Barber, 340B Program Director
(315) 287-3600 Ext: 2423
Signed By Date
1/13/2023
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