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KPH HEALTHCARE SERVICES, INC.
CH0112230 COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION
Subdivision Name
CHC'S OF RUTLAND REGION, INC.
Type
HRSA-Funded Health Center
340B ID
CH0112230
Entity Address
275 Route 30 N
Bomoseen, VT 05732-9647
Grant Number
H80CS06659
Participating Start Date
7/1/2006
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
KPH HEALTHCARE SERVICES, INC.
Pharmacy Address
DBA: KINNEY DRUGS CF
471 E MAIN ST
UNIT 5
GOUVERNEUR, NY 13642
Pharmacy Comments
Contract Details
Approval Date
7/2/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Gardner, CEO
(802) 855-2083
Contract Pharmacy Representative
KPH Healthcare Services, Inc.
Debbi Barber, 340B Program Director
(315) 287-3600 Ext: 2423
Signed By Date
7/2/2024
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