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ADIRONDACK APOTHECARY LLC
CH02179I HUDSON HEADWATERS HEALTH NETWORK
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Covered Entity Details
Entity Name
HUDSON HEADWATERS HEALTH NETWORK
Subdivision Name
Moriah Health Center
Type
HRSA-Funded Health Center
340B ID
CH02179I
Entity Address
33 TOM PHELPS LANE
MINEVILLE, NY 12956
Grant Number
H80CS00159
Participating Start Date
1/1/2007
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
ADIRONDACK APOTHECARY LLC
Pharmacy Address
D B A MORIAH PHARMACY
4315 MAIN ST
PORT HENRY, NY 12974-1339
Pharmacy Comments
Contract Details
Approval Date
1/1/2007
Contract Begin Date
1/1/2007
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
George Purdue, Chief Administrative Officer
(518) 761-0300 Ext: 31114
Contract Pharmacy Representative
REBECCA L. COLE, VICE PRESIDENT
(518) 761-0300
Signed By Date
12/7/2006
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