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MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
CH02179D HUDSON HEADWATERS HEALTH NETWORK
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Covered Entity Details
Entity Name
HUDSON HEADWATERS HEALTH NETWORK
Subdivision Name
BOLTON HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH02179D
Entity Address
11 CROSS STREET
BOLTON LANDING, NY 12814
Grant Number
H80CS00159
Participating Start Date
4/1/2001
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
Pharmacy Address
DBA HANNAFORD SUPERMARKET & PHARMACY #83
27-41 GANSEVOORT ROAD
SOUTH GLENS FALLS, NY 12803
Pharmacy Comments
Contract Details
Approval Date
4/6/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher Tournier, CFO
(518) 761-0300 Ext: 31558
Contract Pharmacy Representative
Hannaford Bros. Co., LLc
Deanne Sargent, Manager Pharmacy Network & Buisness Development
(207) 885-3044
Signed By Date
4/6/2023
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