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KPH HEALTHCARE SERVICES, INC.
CH021240 FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC.
Subdivision Name
FAMILY HEALTH NETWORK OF CENTRAL NEW YORK, INC.
Type
HRSA-Funded Health Center
340B ID
CH021240
Entity Address
85 South West Street
Homer, NY 13077
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
3/30/2010
Contract Begin Date
3/30/2010
Carve-In Effective Date
Contract Comments
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
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