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CRM-CANANDAIGUA, LLC
CH02207J ANTHONY L JORDAN HEALTH CORP
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Covered Entity Details
Entity Name
ANTHONY L JORDAN HEALTH CORP
Subdivision Name
Jordan Health at CCIA
Type
HRSA-Funded Health Center
340B ID
CH02207J
Entity Address
120 N Main St
Canandaigua, NY 14424-1258
Grant Number
H80CS21582
Participating Start Date
2/6/2013
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
CRM-CANANDAIGUA, LLC
Pharmacy Address
CANANDAIGUA THE MEDICINE SHOPPE
75 VICTOR HEIGHTS PKWY STE C
VICTOR, NY 14564-8926
Pharmacy Comments
Contract Details
Approval Date
7/1/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/14/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jonathan Clune, CFO
(585) 423-2813
Contract Pharmacy Representative
CRM Pharmacy
Jeff Hetrick, COO
(716) 830-2518
Signed By Date
7/1/2013
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