Contract Pharmacy Details

TOPS MARKETS
DSH330285 STRONG MEMORIAL HOSPITAL

Covered Entity Details

Entity Name

STRONG MEMORIAL HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH330285

Entity Address

601 Elmwood Avenue
ROCHESTER, NY 14642

Medicare Provider Number

330285

Participating Start Date

10/1/2003

Last Recertification Date

8/18/2024

Pharmacy Details

Pharmacy Name

TOPS MARKETS

Pharmacy Address

C/O PHARMACY
6272 FURNACE RD
ONTARIO, NY 14519

Pharmacy Comments

Contract Details

Approval Date

10/3/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Kevin Segerson, Director of Finance
(585) 341-6686

Contract Pharmacy Representative

John Kirk, Third Party Coordinator
(716) 635-5277

Signed By Date

10/3/2016