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TOPS MARKETS LLC
CH02371BU THE INSTITUTE FOR FAMILY HEALTH
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Covered Entity Details
Entity Name
THE INSTITUTE FOR FAMILY HEALTH
Subdivision Name
Pine Street Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH02371BU
Entity Address
140 Pine Street
Kingston, NY 12401-4948
Grant Number
H80CS00768
Participating Start Date
4/1/2024
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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