340B Drug Pricing Program Database
HOOK-SUPERX, L.L.C.
CHC33650-06 SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC - information as of 5/4/2025 10:36:14 PM
Covered Entity Details
Entity Name
SOUTHERN INDIANA COMMUNITY HEALTH CARE, INC
Subdivision Name
SICHC Mitchell
Type
HRSA-Funded Health Center
340B ID
CHC33650-06
Entity Address
2759 IN-37
Mitchell, IN 47446-6016
Grant Number
H80CS33650
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06875
930 N. GOSPEL ST
PAOLI, IN 47454
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nancy Radcliff, CEO
(812) 723-3944
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/8/2025
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