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KPH HEALTHCARE SERVICES, INC.
CH02124D 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
MORAVIA MEDICAL OFFICE
Type
HRSA-Funded Health Center
340B ID
CH02124D
Entity Address
23 CENTRAL STREET
MORAVIA, NY 13118-3599
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 #07
3666 NYS ROUTE 281
CORTLAND, NY 13045
Pharmacy Comments
Contract Details
Approval Date
9/15/2009
Contract Begin Date
9/15/2009
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
9/8/2009
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