Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
CH0530920 HEALTHLINC, INC.

Covered Entity Details

Entity Name

HEALTHLINC, INC.

Subdivision Name

HealthLinc Valparaiso

Type

HRSA-Funded Health Center

340B ID

CH0530920

Entity Address

1001 Sturdy Rd
Valparaiso, IN 46383

Grant Number

H80CS06662

Participating Start Date

1/1/2004

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 08631
4403 W. WESTERN AVE.
SOUTH BEND, IN 46619

Pharmacy Comments

Contract Details

Approval Date

1/14/2021

Contract Begin Date

4/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

BETH WROBEL, CEO
(219) 465-9500

Contract Pharmacy Representative

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

Signed By Date

1/14/2021

340B Drug Pricing Program Database