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TOPS MARKETS, LLC
CH020180 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 COMMUNITY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH020180
Entity Address
300 West Ave
Brockport, NY 14420-1118
Grant Number
H80CS00170
Participating Start Date
10/14/2008
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
TOPS MARKETS, LLC
Pharmacy Address
TOPS PHARMACY #248
11200 MAPLE RIDGE RD
MEDINA, NY 14103
Pharmacy Comments
Contract Details
Approval Date
7/6/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Emily Miller, CFO
(585) 637-3905
Contract Pharmacy Representative
Tops
David Kulczyk, Regional Pharmacy Manager
(716) 632-7411
Signed By Date
7/6/2023
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