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KPH HEALTHCARE SERVICES, INC.
CHC08746-01 United Cerebral Palsy Association of the North Country, Inc.
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Covered Entity Details
Entity Name
United Cerebral Palsy Association of the North Country, Inc.
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CHC08746-01
Entity Address
380 County Rte.51
MALONE, NY 12953
Grant Number
H80CS08746
Participating Start Date
4/1/2010
Last Recertification Date
2/11/2025
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
7/10/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Bender, CEO
(315) 379-8310
Contract Pharmacy Representative
KPH Healthcare Services
Debbi Barber, 340B Program Director
(315) 287-3600
Signed By Date
7/10/2024
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