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KPH HEALTHCARE SERVICES, INC.
DSH330115 ONEIDA HEALTHCARE CENTER
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Covered Entity Details
Entity Name
ONEIDA HEALTHCARE CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330115
Entity Address
321 GENESEE STREET
ONEIDA, NY 13421
Medicare Provider Number
330115
Participating Start Date
1/1/2015
Last Recertification Date
8/23/2024
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
KPH HEALTHCARE SERVICES, INC.
Pharmacy Address
KINNEY DRUGS #46
540 GENESEE STREET
CHITTENANGO, NY 13037
Pharmacy Comments
Contract Details
Approval Date
12/9/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
John Milligan, CFO
(315) 361-2088
Contract Pharmacy Representative
Kinney Drugs
Debbi Barber, Director of Pharmacy Programs
(315) 287-3600 Ext: 2423
Signed By Date
12/9/2014
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