340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HEALTHDIRECT INSTITUTIONAL PHARMACY SERV
DSH330250 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL
Print
Covered Entity Details
Entity Name
CHAMPLAIN VALLEY PHYSICIANS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330250
Entity Address
75 BEEKMAN STREET
PLATTSBURGH, NY 12901
Medicare Provider Number
330250
Participating Start Date
6/3/2019
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
HEALTHDIRECT INSTITUTIONAL PHARMACY SERV
Pharmacy Address
HEALTHDIRECT INSTITUTIONAL PHARMACY SERV
29 E MAIN ST
GOUVERNEUR, NY 13642
Pharmacy Comments
10/25/10 UPDATED ADDR (WAS GOVERNEUR);
Contract Details
Approval Date
9/15/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/31/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
JOYCE RAFFERTY, VICE PRESIDENT OF FINANCE
(518) 562-7047
Contract Pharmacy Representative
Owen Halloren, VP of Professional Services
(315) 287-3600
Signed By Date
9/15/2014
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session