Contract Pharmacy Details

KPH HEALTHCARE SERVICES, INC.
CH02124D FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC

Covered Entity Details

Entity Name

FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC

Subdivision Name

MORAVIA MEDICAL OFFICE

Type

HRSA-Funded Health Center

340B ID

CH02124D

Entity Address

23 CENTRAL STREET
MORAVIA, NY 13118-3599

Grant Number

H80CS00065

Participating Start Date

1/1/1997

Last Recertification Date

2/24/2025

Pharmacy Details

Pharmacy Name

KPH HEALTHCARE SERVICES, INC.

Pharmacy Address

KINNEY DRUGS #73
130 MAIN STREET
MORAVIA, NY 13118

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

KPH Healthcare Services, Inc.
Debbi Barber, 340B Program Director
(315) 287-3600 Ext: 2423

Signed By Date

1/13/2023

340B Drug Pricing Program Database