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TOPS MARKETS LLC
CH02371A INSTITUTE FOR FAMILY HEALTH, THE
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Covered Entity Details
Entity Name
INSTITUTE FOR FAMILY HEALTH, THE
Subdivision Name
MOUNT HOPE FAMILY PRACTICE
Type
HRSA-Funded Health Center
340B ID
CH02371A
Entity Address
130 W Tremont Ave
Bronx, NY 10453-5436
Grant Number
H80CS00768
Participating Start Date
1/1/2002
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
TOPS MARKETS LLC
Pharmacy Address
TOPS PHARMACY #533
16 JON J WAGNER WAY
LAGRANGEVILLE, NY 12540
Pharmacy Comments
Contract Details
Approval Date
1/16/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Caroline DiCioccio, Chief Financial Officer
(212) 633-0800 Ext: 1409
Contract Pharmacy Representative
Tops
David Kulczyk, Regional Pharmacy Manager
(716) 632-7411
Signed By Date
1/16/2025
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