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DEDRICK'S PHARMACY INC
CH02371AA INSTITUTE FOR FAMILY HEALTH, THE
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Covered Entity Details
Entity Name
INSTITUTE FOR FAMILY HEALTH, THE
Subdivision Name
Pine Grove Health Center
Type
HRSA-Funded Health Center
340B ID
CH02371AA
Entity Address
350 Washington Ave
Kingston, NY 12401-3702
Grant Number
H80CS00768
Participating Start Date
10/1/2007
Last Recertification Date
2/2/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
DEDRICK'S PHARMACY INC
Pharmacy Address
86 N FRONT ST
KINGSTON, NY 12401-3832
Pharmacy Comments
Contract Details
Approval Date
11/6/2012
Contract Begin Date
10/27/2012
Carve-In Effective Date
Contract Comments
11/06/2012 public health emergency declared in the state of NY effective 10/27/2012
Contract Termination Date
Termination Reason
6/28/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Peter Grisafi, Senior Vice President & COO
(212) 633-0800 Ext: 1225
Contract Pharmacy Representative
George S. Nekos, Supervising Pharmacist
(845) 338-8000
Signed By Date
9/17/2012
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