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KPH HEALTHCARE SERVICES, INC.
CHC24165-00 North Country Family Health Center, Inc.
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Covered Entity Details
Entity Name
North Country Family Health Center, Inc.
Subdivision Name
North Country Family Health Center - Main Campus
Type
HRSA-Funded Health Center
340B ID
CHC24165-00
Entity Address
238 Arsenal St
Watertown, NY 13601-2504
Grant Number
H80CS24165
Participating Start Date
10/27/2012
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
KPH HEALTHCARE SERVICES, INC.
Pharmacy Address
KINNEY DRUGS #13
1729 STATE STREET
WATERTOWN, NY 13601
Pharmacy Comments
Contract Details
Approval Date
7/12/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Janice L. Charles, Executive Director
(315) 782-9450
Contract Pharmacy Representative
Kinney Drugs
Debbi Barber, Director of Pharmacy Programs
(315) 287-3600 Ext: 2423
Signed By Date
7/12/2013
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