Contract Pharmacy Details

WEGMANS FOOD MARKETS, INC.
FQHCLA342 TRILLIUM HEALTH, INC.

Covered Entity Details

Entity Name

TRILLIUM HEALTH, INC.

Subdivision Name

Trillium Health at Monroe Square

Type

Health Center Program Look-Alike

340B ID

FQHCLA342

Entity Address

259 Monroe Avenue Suite 100
Rochester, NY 14607-3632

Grant Number

LALCS00182

Participating Start Date

1/1/2017

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WEGMANS FOOD MARKETS, INC.

Pharmacy Address

ATTN: PHARMACY
851 FAIRPORT RD
EAST ROCHESTER, NY 14445

Pharmacy Comments

02/06/2012 changed store #(was 104)

Contract Details

Approval Date

1/15/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/13/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Gregory Clyde Ewing, S.V.P. Compliance, Privacy, Technology & Regulatory Affairs/CCO
(585) 545-7218

Contract Pharmacy Representative

Wegmans
Susan Novotny-Cannata, Manager of Managed Care
(585) 273-6260

Signed By Date

1/15/2020

340B Drug Pricing Program Database