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KPH HEALTHCARE SERVICES, INC.
CH02124I 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-MARATHON ELEMENTARY
Type
HRSA-Funded Health Center
340B ID
CH02124I
Entity Address
24 ALBRO ROAD
MARATHON, NY 13803-0339
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 #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
10/29/2009 -- UPDATED ADDRESS FOR ONE OF THE KINNEY DRUGS PHARMACY IN CORTLAND(WAS 3656 STATE ROUTE 281)
Contract Termination Date
Termination Reason
1/26/2022
Business decision by covered entity and/or pharmacy
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
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