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WALGREEN EASTERN CO., INC.
CH02124A 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
CINCINNATUS MEDICAL OFFICE
Type
HRSA-Funded Health Center
340B ID
CH02124A
Entity Address
2805 CINCINNATUS ROAD
CINCINNATUS, NY 13040-0199
Grant Number
H80CS00065
Participating Start Date
1/1/1997
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #17204
170 PORT WATSON ST
CORTLAND, NY 13045
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kimberly Marie Osborne, Chief Executive Officer
(607) 753-3797
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/13/2023
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