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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 #67
41 ALBANY ST
CAZENOVIA, NY 13035
Pharmacy Comments
Contract Details
Approval Date
1/1/2007
Contract Begin Date
1/1/2007
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
12/12/2006
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