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CLCRESSLER, INC
CH02062C Cornerstone Family Healthcare
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Covered Entity Details
Entity Name
Cornerstone Family Healthcare
Subdivision Name
Mobile Health Van 1
Type
HRSA-Funded Health Center
340B ID
CH02062C
Entity Address
147 Lake St.
Newburgh, NY 12550-5242
Grant Number
H80CS00469
Participating Start Date
7/1/2011
Last Recertification Date
2/2/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
CLCRESSLER, INC
Pharmacy Address
D/B/A THE MEDICINE SHOPPE
1179 VESTAL AVE
SUITE 1
BINGHAMTON, NY 13903
Pharmacy Comments
Contract Details
Approval Date
4/21/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
LINDA S. MULLER, CEO
(845) 220-3130
Contract Pharmacy Representative
The Medicine Shoppe
Daniel Brown, Owner
(814) 641-7442
Signed By Date
4/21/2017
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