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TOPS MARKETS
CH02018N Oak Orchard Community Health Center, Inc.
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Covered Entity Details
Entity Name
Oak Orchard Community Health Center, Inc.
Subdivision Name
Oak Orchard Health at Orleans County MH
Type
HRSA-Funded Health Center
340B ID
CH02018N
Entity Address
14014 State Route 31
Albion, NY 14411-9301
Grant Number
H80CS00170
Participating Start Date
1/1/2021
Last Recertification Date
2/1/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
TOPS MARKETS
Pharmacy Address
TOPS PHARMACY #450
1800 LAKE ROAD
HAMLIN, NY 14464
Pharmacy Comments
Contract Details
Approval Date
1/11/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Emily Miller, CFO
(585) 637-3905
Contract Pharmacy Representative
Tops Markets
David Kulczyk, Pharmacy Manager
(716) 632-7411
Signed By Date
1/11/2023
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