340B Drug Pricing Program Database

Pharmacy Name

KPH HEALTHCARE SERVICES, INC.

Pharmacy Address

KINNEY DRUGS #01
17 CLINTON STREET
GOUVERNEUR, NY 13642

Pharmacy Comments

Approval Date

7/7/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Susan K. Bradley, Pharmacist
(315) 535-9245

Contract Pharmacy Representative

Debbi Barber, Director of PBM Relations
(315) 287-3600 Ext: 2423

Signed By Date

4/2/2014