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KPH HEALTHCARE SERVICES, INC.
CH020560 Mosaic Health, Inc.
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Covered Entity Details
Entity Name
Mosaic Health, Inc.
Subdivision Name
Mosaic Health Finger Lakes Administration
Type
HRSA-Funded Health Center
340B ID
CH020560
Entity Address
1 S Washington Street
Suite 300
Rochester, NY 14614-1134
Grant Number
H80CS00167
Participating Start Date
9/9/2005
Last Recertification Date
2/14/2025
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
10/2/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Joseph Leary, President/CEO
(585) 325-2280 Ext: 7302
Contract Pharmacy Representative
KPH Healthcare Services, Inc.
Debbi Barber, 340B Program Director
(315) 287-3600 Ext: 2423
Signed By Date
10/2/2024
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