Contract Pharmacy Details

WEGMANS FOOD MARKETS, INC.
FQHCLA342B Trillium Health, Inc.

Covered Entity Details

Entity Name

Trillium Health, Inc.

Subdivision Name

Trillium Health Mobile Access Clinic (MAC)

Type

Health Center Program Look-Alike

340B ID

FQHCLA342B

Entity Address

170 Science Pkwy
Rochester, NY 14620-4251

Grant Number

LALCS00182

Participating Start Date

4/1/2020

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WEGMANS FOOD MARKETS, INC.

Pharmacy Address

525 TITUS AVENUE
ATTN: PHARMACY
ROCHESTER, NY 14617

Pharmacy Comments

02/06/2012 changed store # (was 167)

Contract Details

Approval Date

4/15/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

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

4/15/2020

340B Drug Pricing Program Database