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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 #67
41 ALBANY ST
CAZENOVIA, NY 13035
Pharmacy Comments
Contract Details
Approval Date
4/19/2013
Contract Begin Date
4/19/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
WALTER PRIEST, EXECUTIVE DIRECTOR
(607) 753-3797
Contract Pharmacy Representative
Kinney Drugs
Debbi Barber, Director of Pharmacy Programs
(315) 287-3600 Ext: 2423
Signed By Date
4/19/2013
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