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KPH HEALTHCARE SERVICES, INC.
CHC08746-00 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
CHC08746-00
Entity Address
4 COMMERCE LANE
CANTON, NY 13617-3739
Grant Number
H80CS08746
Participating Start Date
7/1/2009
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
KPH HEALTHCARE SERVICES, INC.
Pharmacy Address
KINNEY DRUGS #34
371 EAST MAIN ST
GOUVERNEUR, NY 13642
Pharmacy Comments
Contract Details
Approval Date
1/8/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Charles Sharlow, Chief Financial Officer
(315) 386-1156 Ext: 2010
Contract Pharmacy Representative
Kinney Drugs
Debbi Barber, Director of Pharmacy Programs
(315) 287-3600 Ext: 2423
Signed By Date
1/8/2014
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