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MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
CH010150 COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.
Subdivision Name
Riverside Health Center
Type
HRSA-Funded Health Center
340B ID
CH010150
Entity Address
617 Riverside Ave
Burlington, VT 05401-1601
Grant Number
H80CS00311
Participating Start Date
7/1/1995
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
Pharmacy Address
DBA HANNAFORD SUPERMARKET & PHARMACY #83
21-A ESSEX WAY
ESSEX JUNCTION, VT 05452
Pharmacy Comments
Contract Details
Approval Date
1/6/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeffrey McKee, CEO
(802) 264-8190
Contract Pharmacy Representative
Hannaford
Mike Fish, Pharmacy District Manager
(518) 428-2712
Signed By Date
1/6/2021
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