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MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
CH02371AD INSTITUTE FOR FAMILY HEALTH, THE
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Covered Entity Details
Entity Name
INSTITUTE FOR FAMILY HEALTH, THE
Subdivision Name
FAMILY PRACTICE CENTER OF HYDE PARK
Type
HRSA-Funded Health Center
340B ID
CH02371AD
Entity Address
11 Crum Elbow Rd
Hyde Park, NY 12538-2852
Grant Number
H80CS00768
Participating Start Date
10/1/2007
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
Pharmacy Address
DBA HANNAFORD SUPERMARKET & PHARMACY #83
3650 ROUTE 9W
HIGHLAND, NY 12528
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
Hannaford Supermarket and Pharmacy
Daniel Montagnola, Business Development Manager
(315) 427-5178
Signed By Date
1/16/2025
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