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MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
CH02179AM HUDSON HEADWATERS HEALTH NETWORK
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Covered Entity Details
Entity Name
HUDSON HEADWATERS HEALTH NETWORK
Subdivision Name
Salem Family Health
Type
HRSA-Funded Health Center
340B ID
CH02179AM
Entity Address
1830 County Route 64
Salem, NY 12865-3404
Grant Number
H80CS00159
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
MARTIN'S FOODS OF SOUTH BURLINGTON, LLC
Pharmacy Address
DBA HANNAFORD FOOD & DRUG #8333
1165 ROUTE 29
GREENWICH, NY 12834
Pharmacy Comments
Contract Details
Approval Date
5/29/2025
Contract Begin Date
7/1/2025
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
340B Direct
Ginger Ison, Vice President of Sales
(801) 716-4863
Signed By Date
5/28/2025
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