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TOPS MARKETS
FQHCLA344C Tri-County Family Medicine Program, Inc.
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Covered Entity Details
Entity Name
Tri-County Family Medicine Program, Inc.
Subdivision Name
TCFM Dansville
Type
Health Center Program Look-Alike
340B ID
FQHCLA344C
Entity Address
60 Red Jacket St Ste 1
Dansville, NY 14437-1758
Grant Number
LALCS00181
Participating Start Date
1/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
TOPS MARKETS
Pharmacy Address
TOPS PHARMACY #539
309 W MORRIS STREET
BATH, NY 14810
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nicholas H Apostoleris, CSIO
(585) 432-2300
Contract Pharmacy Representative
Tops
David Kulczyk, Regional Pharmacy Manager
(716) 632-7411
Signed By Date
10/12/2023
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