340B Drug Pricing Program Database


CH053092G HEALTHLINC INC (Active) - information as of 5/20/2025 12:47:33 AM

Main Details
HEALTHLINC INC
HealthLinc IUSB Medical
HRSA-Funded Health Center
BPS-H80-022156
CH053092G
H80CS06662


Additional Details
Active
1/15/2016
4/1/2016
2/10/2016
2/23/2025

Contacts

HealthLinc, Inc.
Melissa D Mitchell, CEO
(219) 465-9503

HealthLinc, Inc.
Nicole M Cimbaljevich, Chief Risk and Compliance Officer
(888) 580-1060 Ext: 5755

Addresses

1960 Northside Blvd
South Bend, IN 46615-1630

HealthLinc, Inc.
2401 Valley Drive
Valparaiso, IN 46383


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailHOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06463 2210 E. EDISON
SOUTH BENDIN4661504/08/202407/01/2024  07/01/2024
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CH0530920ActiveBPS-H80-011362HEALTHLINC INCHealthLinc Valparaiso1001 Sturdy Rd ValparaisoIN
CH053092AActiveBPS-H80-038301HEALTHLINC INCHealthLinc Michigan City200 Alfred St Michigan CityIN
CH053092BActiveBPS-H80-014731HEALTHLINC INCHealthLinc Knox104 E Culver Rd Ste 106 KnoxIN
CH053092CTerminatedBPS-H80-011153HEALTHLINC, INC.HealthLinc - Valparaiso/Porter-Starke Services701 Wall St ValparaisoIN
CH053092DActiveBPS-H80-010640HEALTHLINC INCHealthLinc Mishawaka420 W 4th St MishawakaIN
CH053092EActiveBPS-H80-013501HEALTHLINC INCHealthLinc East Chicago1313 W. Chicago Ave. East ChicagoIN
CH053092FActiveBPS-H80-017419HEALTHLINC INCHealthLinc IUSB Dental1002 S ESTHER ST SOUTH BENDIN
CH053092GActiveBPS-H80-022156HEALTHLINC INCHealthLinc IUSB Medical1960 Northside Blvd South BendIN
CH053092HActiveBPS-H80-024797HEALTHLINC INCHealthLinc Southeast1708 High St South BendIN
CH053092JActiveBPS-H80-024806HEALTHLINC INCHealthLinc Centennial621 Memorial Dr Ste 402 South BendIN
CH053092KActiveBPS-H80-027898HEALTHLINC INCHealthLinc La Porte400 Teegarden St LaporteIN
CH053092LTerminatedBPS-H80-019678Healthlinc, Inc.HealthLinc Clinic Oregon Davis5998 N 750 E Rm 143 HamletIN
CH053092MActiveBPS-H80-032480HEALTHLINC INCHealthLinc East Chicago Harbor2323 Broadway St East ChicagoIN
CH053092NActiveBPS-H80-019125HEALTHLINC INCHealthLinc Corporate2401 Valley Dr ValparaisoIN
CH053092QActiveBPS-H80-038329HEALTHLINC INCHealthLinc East Chicago Harbor West2106 Broadway St East ChicagoIN
CH053092RActiveBPS-H80-039370HEALTHLINC INCHealthLinc La Porte Pediatrics1509 State Street STE B La PorteIN
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CH0530920ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884910/01/2024  
CH0530920ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201010/01/2024  
CH0530920ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750210/01/2024  
CH0530920ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282210/01/2024  
CH0530920ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349210/01/2024  
CH0530920ACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607510/01/2024  
CH0530920BIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771304/01/2024  
CH0530920BIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526104/01/2024  
CH0530920BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 4740 VICTORY LN STE C
INDIANAPOLISIN4620310/01/2024  
CH0530920BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 145 S 79TH ST STE 70
CHANDLERAZ8522610/01/2024  
CH0530920CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361407/01/2021  
CH0530920CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005607/01/2021  
CH053092ECAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005607/01/2024  
CH0530920CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621907/01/2021  
CH0530920CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175707/01/2021  
CH0530920CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808307/01/2021  
CH0530920CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700407/01/2021  
CH0530920CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761707/01/2021  
CH0530920CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107
BARTLETTTN3813307/01/2021  
CH0530920CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A
REDLANDSCA9237407/01/2021  
CH0530920CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911907/01/2021  
CH0530920CENTERWELL PHARMACY, INC.9843 WINDISCH RD
WEST CHESTEROH4506910/01/2024  
CH0530920CORAM ALTERNATE SITE SERVICES, INC.DBA CORAM CVS/SPECIALTY INFUSION SERVICE 431 FERNHILL AVENUE
FORT WAYNEIN4680504/01/2024 01/17/2025
CH0530920CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2022  
CH0530920CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2022  
CH0530920CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502807/01/2021  
CH0530920CYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503301/01/2023  
CH0530920DAMASIUS INC.DBA: VYTO'S PHARMACY 3 4923 HOHMAN AVE
HAMMONDIN4632007/01/2024  
CH0530920DAMASIUS INC.DBA: VYTO'S PHARMACY 2 8845 KENNEDY AVE
HIGHLANDIN46322-190807/01/2024  
CH0530920DAMASIUS INC.DBA: VYTO'S PHARMACY 1 6949 KENNEDY AVE STE C
HAMMONDIN4632307/01/2024  
CH0530920DE MOTTE DRUGSFAGEN PHARMACY #33 5500 HOHMAN AVENUE
SUITE 1A
HAMMONDIN4632006/01/2010 09/16/2017
CH0530920DE MOTTE DRUGS5001 E DUNES HWY
GARYIN4640306/01/2010 09/16/2017
CH0530920DE MOTTE DRUGS, INCDBA: FAGEN PHARMACY #26 1195 E RIDGE RD
GRIFFITHIN4631906/01/2010 09/16/2017
CH0530920DEMOTTE DRUGSFAGEN PHARMACY #2 3892 W. STATE ROAD #10
WHEATFIELDIN4639206/01/2010 09/16/2017
CH0530920DEMOTTE DRUGSDBA FAGEN PHARMACY #18 390 WEST US 6
VALPARAISOIN4638506/01/2010 09/16/2017
CH0530920DEMOTTE DRUGSDBA FAGEN PHARMACY#8 156 FLYNN RD US 421
PO BOX 107
WESTVILLEIN4639106/01/2010 09/16/2017
CH0530920DEMOTTE DRUGS INCDBA:FAGEN PHARMACY #27 7760 E 37TH AVENUE
HOBARTIN4634206/01/2010 09/16/2017
CH0530920DEMOTTE DRUGS INCDBA: FAGEN PHARMACY #1 325 A NORTH HALLECK STREET
P.P. BOX 489
DEMOTTEIN4631006/01/2010 09/16/2017
CH0530920DEMOTTE DRUGS, INC.DBA FAGEN PHARMACY #38 7905 CALUMET AVENUE, SUITE 2
MUNSTERIN4632106/01/2010 09/16/2017
CH0530920DEMOTTE DRUGS, INC.DBA FAGEN PHARMACY #40 251 WEST 84TH DRIVE
MERRILLVILLEIN4641007/01/2016 09/16/2017
CH0530920ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111210/01/2024  
CH0530920EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313410/01/2024  
CH0530920EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2024  
CH0530920EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2024  
CH0530920FAGEN PHARMACY10064 NORTH 600 EAST
DEMOTTEIN4631006/01/2010 09/16/2017
CH0530920FAGEN PHARMACY2080 EAST COMMERICAL AVE.
LOWELLIN4635606/01/2010 09/16/2017
CH0530920FAGEN PHARMACY3400 NORTH CALUMET AVENUE
VALPARAISOIN4638301/01/2014 09/16/2017
CH0530920FAGEN PHARMACY #223612 VILLAGE COURT
GARYIN4640806/01/2010 09/16/2017
CH0530920FAGEN PHARMACY #251301 119TH ST
WHITINGIN4639406/01/2010 09/16/2017
CH0530920FAGEN PHARMACY #28DEMOTTE DRUGS INC. 571 W. 14TH STREET
CHICAGO HEIGHTSIL6041106/01/2010 06/09/2017
CH0530920FAGEN PHARMACY #31DEMOTTE DRUGS INC. 16831 TORRENCE AVENUE
LANSINGIL6043806/01/2010 06/09/2017
CH0530920FAGEN PHARMACY #32DEMOTTE DRUGS INC. 715 DIXIE HIGHWAY
BEECHERIL6040106/01/2010 09/16/2017
CH0530920FAGEN PHARMACY #361350 BROADWAY STREET
GARYIN4640706/01/2010 09/16/2017
CH0530920FAGEN PHARMACY #37710 FRANKLIN STREET
MICHIGAN CITYIN46360-656307/01/2016 09/16/2017
CH053092AFAGEN PHARMACY #37710 FRANKLIN STREET
MICHIGAN CITYIN46360-656310/06/2008 07/01/2016
CH0530920FAGEN PHARMACY #391001 STURDY ROAD, SUITE 201
VALPARAISOIN4638310/06/2008 09/16/2017
CH053092BFAGEN PHARMACY #391001 STURDY ROAD, SUITE 201
VALPARAISOIN4638309/04/2008 07/01/2016
CH053092CFAGEN PHARMACY #391001 STURDY ROAD, SUITE 201
VALPARAISOIN4638310/07/2008 07/01/2016
CH0530920FAGEN PHARMACY #7115 EAST MONTGOMERY P.O. BOX 695
FRANCESVILLEIN4794606/01/2010 09/16/2017
CH0530920HARBOR DRUGS, INC.DBA FAGEN PHARMACY, #23 2106 BROADWAY ST.
EAST CHICAGOIN4631206/01/2010 09/16/2017
CH053092EHARBOR DRUGS, INC.DBA FAGEN PHARMACY, #23 2106 BROADWAY ST.
EAST CHICAGOIN4631201/01/2014 07/01/2016
CH0530920HEALTHLINC PHARMACY, LLC.1001 STURDY RD
VALPARAISOIN4638301/01/2020 04/26/2024
CH0530920HEALTHLINC PHARMACY, LLC.420 W 4TH ST
MISHAWAKAIN46544-194803/30/2020 04/26/2024
CH053092DHEALTHLINC PHARMACY, LLC.420 W 4TH ST
MISHAWAKAIN46544-194807/01/2024 01/01/2025
CH0530920HEALTHY U RX401 E COLFAX AVE STE 159
SOUTH BENDIN4661707/01/2024  
CH0530920HEALTHY U RX INC201 S WILLIAM ST
SOUTH BENDIN46601-251507/01/2024  
CH0530920HOMETOWN PHARMACY #48 - MISHAWAKA606 N MAIN ST
MISHAWAKAIN46545-662007/01/2024  
CH0530920HOOK-SUPERX, L.L.C.DBA CVS/PHARMACY #0434 8100 EAST RIDGE ROAD
HOBARTIN4634201/01/2018  
CH0530920HOOK-SUPERX, L.L.C.DBA CVS/PHARMACY #10936 2106 BROADWAY ST
EAST CHICAGOIN4631212/07/2017 04/12/2022
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06908 310 N. HALLECK ST.
DEMOTTEIN4631001/01/2018  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06910 505 EAST 1100 NORTH
CHESTERTONIN4630401/01/2018  
CH0530920HOOK-SUPERX, L.L.C.DBA CVS/PHARMACY #10925 3612 VILLAGE COURT
GARYIN4640812/07/2017 09/25/2020
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 02520 6445 CALUMET AVE.
HAMMONDIN4632401/01/2018  
CH0530920HOOK-SUPERX, L.L.C.CVS PHARMACY # 17031 8005 CALUMET AVE
MUNSTERIN4632101/01/2018  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06464 210 N. MAIN ST.
MISHAWAKAIN4654401/01/2018  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06915 150 MORTHLAND DRIVE
VALPARAISOIN4638301/01/2018  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06906 107 N. CULLEN ST.
RENSSELAERIN4797801/01/2018  
CH0530920HOOK-SUPERX, L.L.C.DBA CVS/PHARMACY #10964 710 FRANKLIN ST.
MICHIGAN CITYIN4636012/07/2017 04/12/2022
CH0530920HOOK-SUPERX, L.L.C.DBA CVS/PHARMACY #10962 1350 BROADWAY ST
GARYIN4640712/07/2017  
CH0530920HOOK-SUPERX, L.L.C.DBA CVS/PHARMACY #10943 1301 119TH ST
WHITINGIN4639412/07/2017 04/12/2022
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06484 3253 FRANKLIN ST.
MICHIGAN CITYIN4636001/01/2018  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06914 5765 EAST STATE ROAD 10
DEMOTTEIN4631001/01/2018  
CH0530920HOOK-SUPERX, L.L.C.DBA CVS/PHARMACY #10899 3400 N CALUMET AVE
VALPARAISOIN4638301/01/2018 04/12/2022
CH0530920HOOK-SUPERX, L.L.C.DBA CVS/PHARMACY #10824 10809 RANDOLPH ST
CROWN POINTIN4630712/07/2017  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06905 1805 CALUMET AVE.
VALPARAISOIN4638301/01/2018  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06911 3240 WILLOWCREEK RD.,
PORTAGEIN4636801/01/2018  
CH0530920HOOK-SUPERX, L.L.C.DBA CVS/PHARMACY #11190 1195 E RIDGE RD
GRIFFITHIN4631912/07/2017 04/12/2022
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06543 607 E. TALMER AVE.
NORTH JUDSONIN4636610/01/2019  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06538 907 S. HEATON
KNOXIN4653410/01/2019  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06483 1407 LINCOLNWAY
LAPORTEIN4635010/01/2019  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06474 1900 N. MICHIGAN ST.
PLYMOUTHIN4656303/30/2020  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06460 3600 CASSOPOLIS ST.
ELKHARTIN4651403/30/2020  
CH0530920HOOK-SUPERX, L.L.C.CVS PHARMACY # 16630 2420 LAPORTE AVE
VALPARAISOIN4638303/30/2020  
CH0530920HOOK-SUPERX, L.L.C.CVS/PHARMACY # 10176 10 EAST 81ST AVENUE
MERRILLVILLEIN4641003/30/2020  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06469 900 E. BRISTOL ST.
ELKHARTIN4651403/30/2020  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06481 901 N. KARWICK RD.
MICHIGAN CITYIN4636003/30/2020  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06475 104 W. HIVELY AVE.
ELKHARTIN4651703/30/2020  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06485 300 LIBERTY ST.
WALKERTONIN4657403/30/2020  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06537 850 N. PLYMOUTH RD.
WINAMACIN4699603/30/2020  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06539 103 S. OHIO ST.
CULVERIN4651103/30/2020  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06463 2210 E. EDISON
SOUTH BENDIN4661504/01/2021  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06487 2101 EAST IRELAND RD.
SOUTH BENDIN4661404/01/2021  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 08645 4501 LINCOLNWAY EAST
MISHAWAKAIN4654404/01/2021  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 08631 4403 W. WESTERN AVE.
SOUTH BENDIN4661904/01/2021  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 08677 1333 PORTAGE AVE
SOUTH BENDIN4661604/01/2021 03/31/2022
CH0530920HOOK-SUPERX, L.L.C.CVS/PHARMACY #11114 2800 ENTERPRISE ST STE 5
INDIANAPOLISIN46219-110607/01/2021 05/10/2023
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 02387 130 EAST CLEVELAND ROAD
GRANGERIN4653007/01/2021  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06546 1910 MAIN ST.
ROCHESTERIN4697507/01/2021  
CH0530920HOOK-SUPERX, L.L.C.CVS PHARMACY # 17021 1400 E IRELAND RD
SOUTH BENDIN4661410/01/2022  
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 07635 1210 NORTH NAPPANEE ST
ELKHARTIN4651410/01/2022 01/16/2025
CH0530920HOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 08646 51467 STATE ROAD 933
SOUTH BENDIN4663710/01/2022  
CH053092CHOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06905 1805 CALUMET AVE.
VALPARAISOIN4638307/01/2024 04/01/2025
CH053092MHOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 02520 6445 CALUMET AVE.
HAMMONDIN4632407/01/2024  
CH053092NHOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06915 150 MORTHLAND DRIVE
VALPARAISOIN4638307/01/2024  
CH053092GHOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06463 2210 E. EDISON
SOUTH BENDIN4661507/01/2024  
CH053092KHOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06483 1407 LINCOLNWAY
LAPORTEIN4635007/01/2024  
CH053092BHOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06538 907 S. HEATON
KNOXIN4653407/01/2024  
CH053092HHOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 08631 4403 W. WESTERN AVE.
SOUTH BENDIN4661907/01/2024  
CH053092FHOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06484 3253 FRANKLIN ST.
MICHIGAN CITYIN4636007/01/2024  
CH053092JHOOK-SUPERX, L.L.C.DBA: CVS/PHARMACY # 06487 2101 EAST IRELAND RD.
SOUTH BENDIN4661407/01/2024  
CH0530920INDIANA PHARMACY ALLIANCE INCDBA VALLEY PHARMACY 325A N HALLECK ST
DEMOTTEIN4631004/01/2025  
CH0530920KROGER COLUMBUS CENTRAL FILL #0192270 RICKENBACKER PKWY W
COLUMBUSOH4321710/01/2020  
CH0530920KROGER SAV-ON PHARMACY J9031217 E IRELAND RD
SOUTH BENDIN4661410/01/2020  
CH0530920KROGER SAV-ON PHCY J-938906 S MERRIFIELD AVE
MISHAWAKAIN4654410/01/2020  
CH0530920PHIL'S DISCOUNT DRUGS702 E LINCOLNWAY
LA PORTEIN4635007/01/2024  
CH0530920PHIL'S HEALTH MART PHARMACY3535 S FRANKLIN ST
MICHIGAN CITYIN4636007/01/2024  
CH0530920PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514607/01/2021  
CH0530920PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920307/01/2021  
CH0530920PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523307/01/2021  
CH0530920PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1
HONOLULUHI9681307/01/2021  
CH0530920QUALITY CARE PHARMACY, LLC4708 W WESTERN AVE SUITE A
SOUTH BENDIN46619-251504/01/2019 02/08/2022
CH0530920SCHOLL PHARMACY INCDBA FAGEN PHARMACY #14 10809 RANDOLPH STREET
CROWN POINTIN4630706/01/2010 09/16/2017
CH0530920THE KROGER PHARMACY #9014526 WESTERN AVE
SOUTH BENDIN4661910/01/2020 11/11/2023
CH0530920THE KROGER PHARMACY #96655 PINE LAKE AVE
LA PORTEIN46350-302710/01/2020  
CH0530920WAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738601/01/2022  
CH0530920WAL-MART PHARMACY 10-14875780 FRANKLIN ST
MICHIGAN CITYIN4636001/01/2022  
CH0530920WAL-MART PHARMACY 10-19782505 NORTH OAK RD
PLYMOUTHIN4656301/01/2022  
CH0530920WAL-MART PHARMACY 10-2020905 S. COLLEGE AVE
RENSSELAERIN4797801/01/2022  
CH0530920WAL-MART PHARMACY 10-2276333 BOYD BLVD
LAPORTEIN4635001/01/2022  
CH0530920WAL-MART PHARMACY 10-25446087 U S HWY 6
PORTAGEIN4636801/01/2022  
CH0530920WAL-MART PHARMACY 10-2678316 INDIAN RIDGE ROAD
MISHAWAKAIN4654501/01/2022  
CH0530920WAL-MART PHARMACY 10-2679175 COUNTY ROAD #6 WEST
ELKHARTIN4651401/01/2022  
CH0530920WAL-MART PHARMACY 10-26803701 PORTAGE ROAD
SOUTH BEND (N)IN4662801/01/2022 04/21/2023
CH0530920WAL-MART PHARMACY 10-28187850 CABELA DRIVE
HAMMONDIN4632401/01/2022  
CH0530920WAL-MART PHARMACY 10-3436700 WEST IRELAND ROAD
SOUTH BENDIN4661401/01/2022  
CH0530920WAL-MART PHARMACY 10-439930830 OLD US 20
ELKHARTIN4651401/01/2022  
CH0530920WAL-MART PHARMACY 10-46311100 5TH AVENUE
HAMMONDIN4632001/01/2022  
CH0530920WAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283701/01/2022  
CH0530920WALGREEN CODBA: WALGREENS #11795 3551 CASSOPOLIS STREET
ELKHARTIN46514-674310/01/2022  
CH0530920WALGREEN CO.DBA: WALGREENS # 03437 1010 E IRELAND RD
SOUTH BENDIN4661404/01/2014  
CH0530920WALGREEN CO.DBA: WALGREENS # 03680 1903 CALUMET AVE.
VALPARAISOIN4638304/01/2014  
CH0530920WALGREEN CO.DBA: WALGREENS # 04635 101 W HWY 20
MICHIGAN CITYIN4636004/01/2014  
CH0530920WALGREEN CO.DBA: WALGREENS # 04946 580 INDIAN BOUNDARY RD
CHESTERTONIN4630404/01/2014  
CH0530920WALGREEN CO.DBA: WALGREENS # 05241 252 MORTHLAND DRIVE
VALPARAISOIN4638304/01/2014  
CH0530920WALGREEN CO.DBA: WALGREENS # 07418 1207 S HEATON ST
KNOXIN46534-231104/01/2014  
CH0530920WALGREEN CO.DBA: WALGREENS # 09482 110 E. MCKINLEY AVE
MISHAWAKAIN4654504/01/2014  
CH0530920WALGREEN CO.DBA: WALGREENS #11084 1816 FRANKLIN ST
MICHIGAN CITYIN4636004/01/2014  
CH0530920WALGREEN CO.DBA: WALGREENS # 12344 1945 LINCOLNWAY E.
SOUTH BENDIN4661304/01/2014 11/07/2019
CH0530920WALGREEN CO.DBA: WALGREENS # 04560 5995 US HWY. 6
PORTAGEIN4636804/01/2015  
CH0530920WALGREEN CO.DBA: WALGREENS # 09220 2845 W CLEVELAND RD
SOUTH BENDIN4662804/01/2015  
CH0530920WALGREEN CO.DBA: WALGREENS # 10124 1400 CASSOPOLIS ST
ELKHARTIN46514-324604/01/2015  
CH0530920WALGREEN CO.DBA: WALGREENS # 10184 1351 N IRONWOOD DR
SOUTH BENDIN46615-356604/01/2015  
CH0530920WALGREEN CO.DBA: WALGREENS # 11085 52482 INDIANA STATE RTE 933
SOUTH BENDIN46637-385204/01/2015  
CH0530920WALGREEN CO.DBA: WALGREENS # 11623 102 E HIVELY AVE
ELKHARTIN4651704/01/2015 03/18/2025
CH0530920WALGREEN CO.DBA: WALGREENS #11625 4620 LINCOLNWAY EAST
MISHAWAKAIN4654404/01/2015  
CH0530920WALGREEN CO.DBA: WALGREENS # 12074 308 NORTH MAIN STREET
HEBRONIN4634104/01/2015  
CH0530920WALGREEN CO.DBA: WALGREENS #12264 200 S NAPPANEE
ELKHARTIN4651404/01/2015  
CH0530920WALGREEN CO.DBA: WALGREENS #12585 4444 W. WESTERN AVENUE
SOUTH BENDIN4661904/01/2015 11/07/2019
CH0530920WALGREEN CO.DBA: WALGREENS #13949 6001 CENTRAL AVE
PORTAGEIN46368-350604/01/2015  
CH0530920WALGREEN CO.DBA: WALGREENS # 07631 720 W CHICAGO AVE
EAST CHICAGOIN46312-322207/01/2016 11/06/2019
CH0530920WALGREEN CO.DBA: WALGREENS # 05628 4445 CALUMET AVE
HAMMONDIN4632707/01/2016  
CH0530920WALGREEN CO.DBA: WALGREENS # 10529 2123 E COLUMBUS DR.
EAST CHICAGOIN4631207/01/2016  
CH0530920WALGREEN CO.DBA: WALGREENS # 04462 6510 COLUMBIA AVE.
HAMMONDIN4632007/01/2016  
CH0530920WALGREEN CO.DBA: WALGREENS # 09100 2014 N MICHIGAN ST
PLYMOUTHIN46563-104807/01/2016  
CH0530920WALGREEN CO.DBA: WALGREENS # 10534 1939 INDIANAPOLIS BLVD.
WHITINGIN4639407/01/2016  
CH0530920WALGREEN CO.DBA: WALGREENS # 05141 1302 W SR 2
LAPORTEIN4635004/01/2018  
CH0530920WALGREEN CO.DBA: WALGREENS # 09318 525 E LINCOLNWAY
LAPORTEIN46350-383304/01/2018  
CH0530920WALGREEN CO.DBA: WALGREENS SPECIALTY PHARMACY #16317 335 MASSACHUSETTS AVENUE
INDIANAPOLISIN4620407/01/2019  
CH0530920WALGREEN CO.DBA: WALGREENS # 09290 2500 GRANT ST
GARYIN46404-350803/30/2020  
CH0530920WALGREEN CO.DBA: WALGREENS # 12109 7236 CALUMET AVE
HAMMONDIN4632401/01/2022  
CH0530920WALGREEN CO.DBA: WALGREENS # 03352 6905 KENNEDY AVE
HAMMONDIN4632301/01/2022  
CH0530920WALGREEN CO.DBA: WALGREENS # 04241 1225 E. RIDGE RD.
GRIFFITHIN4631901/01/2022  
CH0530920WALGREEN CO.DBA: WALGREENS # 04668 1003 N MAIN STREET
CROWN POINTIN4630710/01/2022  
CH0530920WALGREEN CO.DBA: WALGREENS # 03232 429 W. PIKE STREET
GOSHENIN4652610/01/2022  
CH0530920Walgreens Central Fill #213994132Plainfield Rd
Ste 110
IndianapolisIN46231-702104/01/2023  
CH0530920WALGREENS MAIL SERVICE, INC.8350 S RIVER PARKWAY
TEMPEAZ8528404/01/2014 07/01/2015
CH0530920WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503301/01/2023  
CH0530920WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818801/01/2023  
CH0530920WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527501/01/2023  
CH0530920WALMART PHARMACY 10-3654808 WEST WALNUT STREET
ROGERSAR7275607/01/2023 07/01/2023
CH0530920WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A
ROGERSAR7275601/01/2024  
CH0530920Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesMain AddressUpdateChange Request 1960 Northside Blvd South Bend, IN 46615 1960 Northside Blvd South Bend, IN 46615-16305/13/2025 6:55 AM
DetailsEntity NameUpdateChange RequestHEALTHLINC, INC.HEALTHLINC INC5/13/2025 6:55 AM
DetailsLast Recertification DateUpdateRecertification2/9/2024 2:28:38 PM2/23/2025 1:02:50 PM2/23/2025 1:02 PM
DetailsEntity SubnameUpdateRecertificationHealthLinc South Bend (medical)HealthLinc IUSB Medical2/23/2025 1:02 PM
ContactsPrimary ContactUpdateChange RequestLaciak, Marjie 340B Compliance Pharmacist HealthLinc, Inc. 2194627173-2990Cimbaljevich, Nicole M Chief Risk and Compliance Officer HealthLinc, Inc. 8885801060-57557/17/2024 12:49 PM
DetailsLast Recertification DateUpdateRecertification1/30/2023 9:21:03 PM2/9/2024 2:28:38 PM2/9/2024 2:28 PM
ContactsAuthorizing OfficialUpdateAO Change RequestWROBEL, BETH CEO HealthLinc 2194659500Mitchell, Melissa D CEO HealthLinc, Inc. 219465950311/17/2023 6:13 PM
ContactsPrimary ContactUpdatePC Change RequestThoma, Lynn Director of Pharmacy HealthLinc 2194627173-2608Laciak, Marjie 340B Compliance Pharmacist HealthLinc, Inc. 2194627173-299010/16/2023 10:02 AM
DetailsLast Recertification DateUpdateRecertification2/1/2022 7:20:14 AM1/30/2023 9:21:03 PM1/30/2023 9:21 PM
DetailsLast Recertification DateUpdateRecertification2/3/2021 7:12:20 AM2/1/2022 7:20:14 AM2/1/2022 7:20 AM
DetailsLast Recertification DateUpdateRecertification1/30/2020 6:10:38 AM2/3/2021 7:12:20 AM2/3/2021 7:12 AM
DetailsLast Recertification DateUpdateRecertification1/30/2019 9:11:03 AM1/30/2020 6:10:38 AM1/30/2020 6:10 AM
ContactsPrimary ContactUpdateProfile Change RequestFletcher, Lynn Director of Pharmacy HealthLinc 2194627173-2608Thoma, Lynn Director of Pharmacy HealthLinc 2194627173-260811/4/2019 7:06 PM
AddressesBilling AddressInsertChange Request HealthLinc, Inc. 2401 Valley Drive Valparaiso, IN 463834/4/2019 9:35 PM
DetailsLast Recertification DateUpdateRecertification2/11/2018 11:57:13 AM1/30/2019 9:11:03 AM1/30/2019 9:11 AM
AddressesMain AddressUpdateChange Request 941 20th Street South Bend, IN 46615-1607 1960 Northside Blvd South Bend, IN 466158/2/2018 1:28 PM
DetailsIs Authorizing Official EHB DataUpdateChange RequestFalse 8/2/2018 1:28 PM
DetailsEntity SubnameUpdateChange RequestHealthLinc South Bend (medical) tempHealthLinc South Bend (medical)8/2/2018 1:28 PM
DetailsLast Recertification DateUpdateRecertification2/7/2017 12:00:00 AM2/11/2018 11:57:13 AM2/11/2018 11:57 AM
ContactsAuthorizing OfficialUpdate WROBEL, BETH CEO 2194659500WROBEL, BETH CEO HealthLinc 219465950010/16/2017 3:27 PM
ContactsSigned ByUpdate WROBEL, BETH CEO 2194659500WROBEL, BETH CEO HealthLinc 219465950010/16/2017 3:27 PM
ContactsPrimary ContactUpdate Fletcher, Lynn Director of Pharmacy 2194627173-2608Fletcher, Lynn Director of Pharmacy HealthLinc 2194627173-260810/12/2017 7:11 AM
ContactsAuthorizing OfficialInsert  WROBEL, BETH CEO 21946595006/8/2017 9:23 PM
ContactsSigned ByInsert  WROBEL, BETH CEO 21946595006/8/2017 9:23 PM
ContactsPrimary ContactUpdate Rundle, Sharon DON 2194135100-2717Fletcher, Lynn Director of Pharmacy 2194627173-26084/22/2017 8:59 AM
AddressesMain AddressInsert   941 20th Street South Bend, IN 46615-16074/22/2017 8:57 AM
ContactsPrimary ContactInsert  Rundle, Sharon DON 2194135100-27172/7/2017 2:35 PM
DetailsLast Recertification DateUpdate  2/7/2017 12:00:00 AM2/7/2017 2:35 PM
DatesParticipating Approval DateUpdate  2/10/2016 12:00:00 AM2/10/2016 5:12 PM
DetailsStateUpdate PendingActive2/10/2016 5:12 PM
DatesStart DateUpdate  4/1/2016 12:00:00 AM2/10/2016 5:12 PM
Details340B IDUpdate ONLINE_REG_58220CH053092G1/19/2016 2:03 PM
Details340B IDUpdate ONLINE_REGONLINE_REG_582201/15/2016 11:32 AM
DetailsLast Recertification DateInsert   1/15/2016 11:32 AM
DetailsGrant NumberInsert  H80CS066621/15/2016 11:32 AM
Details340B IDInsert  ONLINE_REG1/15/2016 11:32 AM
DetailsIs Authorizing Official EHB DataInsert  False1/15/2016 11:32 AM
DatesLast Date That 340B Drugs PurchasedInsert   1/15/2016 11:32 AM
DetailsMedicare Provider NumberInsert   1/15/2016 11:32 AM
DetailsEntity NameInsert  HEALTHLINC, INC.1/15/2016 11:32 AM
DetailsProgram CodeInsert  CH1/15/2016 11:32 AM
DetailsEntity SubnameInsert  HealthLinc South Bend (medical) temp1/15/2016 11:32 AM
DatesParticipating Approval DateInsert   1/15/2016 11:32 AM
DetailsStateInsert  Pending1/15/2016 11:32 AM
DatesRegistration DateInsert  1/15/2016 12:00:00 AM1/15/2016 11:32 AM
DatesSigned By DateInsert  1/15/2016 12:00:00 AM1/15/2016 11:32 AM
DatesStart DateInsert   1/15/2016 11:32 AM
TerminationsTermination CommentsInsert   1/15/2016 11:32 AM
TerminationsTermination DateInsert   1/15/2016 11:32 AM
TerminationsTermination Effective DateInsert   1/15/2016 11:32 AM
TerminationsTermination ReasonInsert   1/15/2016 11:32 AM