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CRM-CANANDAIGUA, LLC
CH022070 ANTHONY L JORDAN HEALTH CORP
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Covered Entity Details
Entity Name
ANTHONY L JORDAN HEALTH CORP
Subdivision Name
Main Site
Type
HRSA-Funded Health Center
340B ID
CH022070
Entity Address
82 Holland St
Rochester, NY 14605-2131
Grant Number
H80CS21582
Participating Start Date
10/1/2011
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CRM-CANANDAIGUA, LLC
Pharmacy Address
CANANDAIGUA THE MEDICINE SHOPPE
75 VICTOR HEIGHTS PKWY STE C
VICTOR, NY 14564-8926
Pharmacy Comments
Contract Details
Approval Date
10/14/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/14/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jonathan Clune, CFO
(585) 423-2813
Contract Pharmacy Representative
CRM Pharmacy
Jeff Hetrick, COO
(716) 830-2518
Signed By Date
10/14/2013
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