Contract Pharmacy Details

KPH HEALTHCARE SERVICES, INC.
CH02124F FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC

Covered Entity Details

Entity Name

FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC

Subdivision Name

FAMILY HEALTH NETWORK DENTAL OFFICE

Type

HRSA-Funded Health Center

340B ID

CH02124F

Entity Address

24 GROTON AVENUE
CORTLAND, NY 13045

Grant Number

H80CS00065

Participating Start Date

1/1/2007

Last Recertification Date

3/7/2016

Entity Termination Date

4/1/2016

Pharmacy Details

Pharmacy Name

KPH HEALTHCARE SERVICES, INC.

Pharmacy Address

KINNEY DRUGS #07
3666 NYS ROUTE 281
CORTLAND, NY 13045

Pharmacy Comments

Contract Details

Approval Date

9/15/2009

Contract Begin Date

9/15/2009

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2016

Contacts

Covered Entity Signing Official

WALTER PRIEST, EXECUTIVE DIRECTOR
(607) 753-3797

Contract Pharmacy Representative

Owen Halloran, Senior Vice President, Pharmacy Procurement
(315) 287-3600 Ext: 263

Signed By Date

9/8/2009

340B Drug Pricing Program Database