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MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
CH02179AJ HUDSON HEADWATERS HEALTH NETWORK
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Covered Entity Details
Entity Name
HUDSON HEADWATERS HEALTH NETWORK
Subdivision Name
Glens Falls Family Health
Type
HRSA-Funded Health Center
340B ID
CH02179AJ
Entity Address
38 Larose St
Glens Falls, NY 12801-3452
Grant Number
H80CS00159
Participating Start Date
4/1/2024
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
Pharmacy Address
DBA HANNAFORD SUPERMARKET & PHARMACY #83
190 QUAKER ROAD
QUEENSBURY, NY 12804
Pharmacy Comments
Contract Details
Approval Date
1/5/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laura Pasco, EVP, Chief Financial Officer
(518) 761-0300 Ext: 31553
Contract Pharmacy Representative
Hannaford Bros. Co., LLc
Deanne Sargent, Manager Pharmacy Network & Buisness Development
(207) 885-3044
Signed By Date
1/3/2024
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