Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
FQHCLA354 ASPIRE HEALTH CENTER

Covered Entity Details

Entity Name

ASPIRE HEALTH CENTER

Subdivision Name

Aspire Indiana Health - Carmel

Type

Health Center Program Look-Alike

340B ID

FQHCLA354

Entity Address

697 Pro-med Lane
Carmel, IN 46032-5323

Grant Number

LALCS31260

Participating Start Date

1/1/2018

Last Recertification Date

3/4/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06667
201 SOUTH JACKSON STREET
FRANKFORT, IN 46041

Pharmacy Comments

Contract Details

Approval Date

4/14/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jerry Landers, VP, Strategy & Business Development
(317) 587-0508

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

4/14/2020

340B Drug Pricing Program Database