Contract Pharmacy Details

KPH HEALTHCARE SERVICES, INC.
CH02124E FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC

Covered Entity Details

Entity Name

FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC

Subdivision Name

CORTLAND MEDICAL OFFICE

Type

HRSA-Funded Health Center

340B ID

CH02124E

Entity Address

4038 WEST ROAD
CORTLAND, NY 13045-1148

Grant Number

H80CS00065

Participating Start Date

1/1/1997

Last Recertification Date

2/24/2025

Pharmacy Details

Pharmacy Name

KPH HEALTHCARE SERVICES, INC.

Pharmacy Address

KINNEY DRUGS #36
14 CLINTON AVENUE
CORTLAND, NY 13045-2197

Pharmacy Comments

Contract Details

Approval Date

9/18/2006

Contract Begin Date

9/18/2006

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/26/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

9/9/2006

340B Drug Pricing Program Database