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VIC VENA PHARMACY INC
CHC24140-02 Southern Tier Community Health Center Network
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Covered Entity Details
Entity Name
Southern Tier Community Health Center Network
Subdivision Name
Southern Tier Community Health Center Network, Houghton site
Type
HRSA-Funded Health Center
340B ID
CHC24140-02
Entity Address
9864 Luckey Dr
Houghton, NY 14744-8706
Grant Number
H80CS24140
Participating Start Date
3/1/2013
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
VIC VENA PHARMACY INC
Pharmacy Address
D B A VENA VIC PHARMACY INC
1322 WEST STATE ST
OLEAN, NY 14760-2036
Pharmacy Comments
Contract Details
Approval Date
7/2/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Gail C. Speedy, Executive Director
(716) 375-7500 Ext: 6831
Contract Pharmacy Representative
Southern Tier Community Health Center Network, Inc.
Gail Speedy Mayeaux, Executive Director
(716) 375-7500 Ext: 6831
Signed By Date
7/2/2013
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