Contract Pharmacy Details

MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
CHC10611-04 Lamoille Health Partners, Inc.

Covered Entity Details

Entity Name

Lamoille Health Partners, Inc.

Subdivision Name

Lamoille Health Family Medicine, Stowe

Type

HRSA-Funded Health Center

340B ID

CHC10611-04

Entity Address

1878 MOUNTAIN ROAD, STE 3
STOWE, VT 05672

Grant Number

H80CS10611

Participating Start Date

4/1/2008

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

MARTIN'S FOODS OF SOUTH BURLINGTON, LLC

Pharmacy Address

DBA HANNAFORD SUPERMARKET & PHARMACY #81
80 FAIRGROUNDS PLZ
MORRISVILLE, VT 05661

Pharmacy Comments

Contract Details

Approval Date

7/15/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Stuart G May, President / CEO
(802) 888-0901

Contract Pharmacy Representative

Hannaford
Mike Fish, Pharmacy District Manager
(518) 428-2712

Signed By Date

7/15/2021

340B Drug Pricing Program Database