Contract Pharmacy Details

KPH HEALTHCARE SERVICES, INC.
CH02124B FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC

Covered Entity Details

Entity Name

FAMILY HEALTH NETWORK OF CENTRAL NEW YORK INC

Subdivision Name

MARATHON MEDICAL OFFICE

Type

HRSA-Funded Health Center

340B ID

CH02124B

Entity Address

20 E MAIN STREET
MARATHON, NY 13803-3208

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 #82
44 NORTH STREET
DRYDEN, NY 13053

Pharmacy Comments

Contract Details

Approval Date

4/8/2010

Contract Begin Date

4/8/2010

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

WALTER PRIEST, EXECUTIVE DIRECTOR
(607) 753-3797

Contract Pharmacy Representative

Owen Halloran, Senior Vice President, Pharmacy Procurement
(315) 287-3600 Ext: 263

Signed By Date

1/26/2010

340B Drug Pricing Program Database