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THE GOLUB CORPORATION
CH02124E 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
CORTLAND MEDICAL OFFICE
Type
HRSA-Funded Health Center
340B ID
CH02124E
Entity Address
4038 WEST ROAD
CORTLAND, NY 13045-1148
Grant Number
H80CS00065
Participating Start Date
1/1/1997
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
THE GOLUB CORPORATION
Pharmacy Address
PRICE CHOPPER PHARMACY 178
854 STATE ROUTE 13
CORTLAND, NY 13045
Pharmacy Comments
Contract Details
Approval Date
7/8/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kimberly Marie Osborne, Chief Executive Officer
(607) 753-3797
Contract Pharmacy Representative
Golub Corporation
Scott Guisinger, Vice President of Pharmacy
(518) 379-2409
Signed By Date
7/8/2024
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