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PA Bulletin, Doc. No. 12-1386

NOTICES

Special Supplemental Nutrition Program for Women, Infants and Children (WIC Program); Retail Store Alert—Listing of Licensed Infant Formula Sellers

[42 Pa.B. 4670]
[Saturday, July 21, 2012]

 According to the Child Nutrition and WIC Reauthorization Act of 2004 (Pub. L. No. 108-265), each state agency is required to maintain a list of infant formula wholesalers, distributors and retailers licensed in the state in accordance with state law, and of infant formula manufacturers registered with the Food and Drug Administration.

 Authorized WIC vendors are only permitted to purchase infant formula from the List of Licensed Infant Formula Wholesalers, Distributors, Retailers, and Manufacturers.

 As requested in the Retail Store Alert dated February 14, 2012, many WIC authorized stores provided the names of formula sellers. These sellers were contacted and required to submit their current ''Department of Agriculture Bureau of Food Safety and Laboratory Services Wholesale Registration'' certification. The sellers who provided a valid certificate are listed on the following Licensed Infant Formula Seller List. These sellers and all Commonwealth WIC authorized vendors make up the Licensed Infant Formula Sellers. The current list is available on the Vendor Assistant web site as the Retail Store Alert identified as 2012-07-02 Actual List of Licensed Infant Formula Sellers.

 When ordering infant formula, refer to the sellers on the following list or purchase from a WIC authorized vendor who can be identified by the red PA WIC decal located on the entrance door of the store.

 Also, WIC authorized stores must maintain purchase records and records used for Federal tax reporting purposes for allowable foods for a minimum of 2 years in accordance with 28 Pa. Code § 1105.3(16) (relating to terms and conditions of participation).

 Purchasing infant formula from a seller who is not on the approved List of Licensed Infant Formula Wholesalers, Distributors, Retailers, and Manufacturers may result in disqualification from the WIC Program.

 Individuals with questions should contact the Retail Store Section of the Division of WIC at (717) 783-1289.

 The following Retail Store Alert is also available on the Vendor Assistant web site at https://wic.health.state.pa.us/vendorassistant/ or at PAWIC.com.

Pennsylvania Licensed Infant Formula Sellers

ACME Inc. #8790
500 South Muddy Creek Road
Denver, PA 17517
American Seaway/Riser Foods
(Giant Eagle)
5300 Richmond Road
Bedford, OH 44146
Associated Wholesalers Inc. (AWI)
Corporate Headquarters:
Route 422
P. O. Box 67
Robesonia, PA 19551
AWI
600 Aresenal Road
York, PA 17402
B & B Wholesale
2015 West Allegheny Avenue
Philadelphia, PA 19132
B & T Wholesale
123 West Hamilton St.
Allentown, PA 18102
Bells Wholesale
211 Meadowridge Road
Mt. Morris, PA 15349
Bristol-Myers Squibb Company
Mead Johnson Nutritional Group
2400 West Lloyd Expressway
Evansville, IN 47721
C&S Supermarkets
General Corp./Pathmark Stores
200 Milik Street
Cateret, NJ 07008
C&S Bethlehem
4930 Hanoverville Rd
Bethlehem, PA 18020
C&S Blandon
1060 Park Road
Blandon, PA 19510
C&S Harrisburg
100 Quality Circle
Suite 100
Harrisburg, PA 17112
C&S Wholesalers
47 Old Ferry Road
P. O. Box 821
Brattleboro, VT 05301
C&S Wholesalers
301 Blair Road
Avenel, NJ 07001
C&S York
4875 Susquehanna Trail
York, PA 17406
Cooper Booth Wholesale CO LP
200 Lincoln West Drive
Mountville, PA 17554
Core Mark Midcontinent Inc.
100 West End Rd
Hanover Township, PA 18706
DG Inc/ White Rose Foods (AWI)
380 Middlesex Avenue
Carteret, NJ 07008
DuBois Logistics LLC (C&S)
891 Beaver Drive
Dubois, PA 15801
F & M Trading LLC
456 North Delaware Avenue
Philadelphia, PA 19123
Food Lion Distribution Center #7
Lot 16 Commerce Avenue
Greencastle, PA 17225
Giant Eagle, Inc.
755 Beechnut Drive
Pittsburgh, PA 15205
Giant Food Stores LLC
1149 Harrisburg Pike
Carlisle, PA 17013
Jetro Cash & Carry
700 Pattison Avenue
Philadelphia, PA 19148
K & J Wholsale, Inc.
750 W. Sedgley Avenue
Philadelphia, PA 19140
K & T Wholesale Distributor, Inc.
161 East Hunting Park Avenue
Philadelphia, PA 19124
Krasdale Foods—Bronx, NY
400 Food Center Drive
Bronx, PA 10474
Krasdale Foods—White Plains, NY
65 West Red Oak Lane
White Plains, NY 10604
Lee's Wholesale & Distribution/Jetro
700 Pattison Avenue
Philadelphia, PA 19148
MKT &A Inc.
2626 Penns Ridge Boulevard
Easton, PA 18040
Nestle USA
800 North Brand Boulevard
Glendale, CA 91203
OK Grocery Company Warehouse
755 Beechnut Drive
Pittsburgh, PA 15205
Olean Wholesale
P. O. Box 1070
1587 Haskell Road
Olean, NY 14760
PBM Nutritionals, LLC
P. O. Box 2109
147 Industrial Park Road
Georgia, VT 05468
PNK Wholesale
413-39 Rising Sun Avenue
Philadelphia, PA 19140
Ross Products - Abbott Laboratories
625 Cleveland Avenue
Columbus, OH 73215
S & K Import, Inc.
4001 G Street
Philadelphia, PA 19124
Save A Lot
2692 Sidley Court
Austinburg, OH 44010
Sherman St. Cash & Carry
1240 B North Sherman St.
Allentown, PA 18109
Shop N Save #80123
1906 Dailey Avenue
Latrobe, PA 15605
Solus Products, LLC
8910 Purdue Road
Suite 230
Indianapolis, IN 46268
Supervalu
Corporate Address:
11840 Valley View Road
Eden Prairie, MN 55344
Supervalu
8258 Richfood Road
Mechanicsville, VA 23116
Supervalu Eastern Region
3900 Industrial Road
Harrisburg, PA 17110
Supervalu/ACME Distribution Center
500 South Muddy Creek Road
Denver, PA 17517
Supervalue
400 Painterville Road
New Stanton, PA 15657
Sysco Philadelphia LLC
600 Packer Avenue
Philadelphia, PA 19148
Tripifoods Inc
1427 William Street
Buffalo, NY 14206
Wakefern Food Corporation
600 York Street
Elizabeth, NJ 07207
Wal-Mart DC # 6027
100 Walmart Drive
Woodland, PA 16881
Wal-Mart DC # 6047
181 Walmart Road
Bedford, PA 15522
Wal-Mart DC # 6080
100 Veterans Drive
Tobyhanna, PA 18466
Wegman's Retail Service Center
820 Keystone Boulevard
Pottsville, PA 17901
Weis Distribution Ctr. Warehouse
Industrial Park
Milton, PA 17847
Weis Markets, Inc.
1000 South Second Street
Sunbury, PA 17801
PA-WIC Authorized Stores displaying the red WIC logo on their entrance doors are also Licensed Infant Formula Sellers

 Persons with a disability who require an alternative format of this notice (for example, large print, audiotape, Braille) should contact Chris Harr, Department of Health, Division of WIC, 2150 Herr Street, 1st Floor, Harrisburg, PA 17105, (717) 783-1289, or for speech and/or hearing impaired persons V/TT (717) 783-6514, or the Pennsylvania AT&T Relay Service at (800) 654-5984.

ELI N. AVILA, MD, JD, MPH, FCLM, 
Secretary

[Pa.B. Doc. No. 12-1386. Filed for public inspection July 20, 2012, 9:00 a.m.]



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