340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HOOK-SUPERX, L.L.C.
CAH151313-00 WOODLAWN HOSPITAL
Print
Covered Entity Details
Entity Name
WOODLAWN HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH151313-00
Entity Address
1400 EAST 9TH STREET
ROCHESTER, IN 46975
Medicare Provider Number
151313
Participating Start Date
1/1/2019
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06535
831 NORTH MAIN STREET
MONTICELLO, IN 47960
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Carl John Kraft, Vice Pesident
(574) 224-1118
Contract Pharmacy Representative
Wellpartner
Joshua Thevenin, Account Manager
(646) 761-3048
Signed By Date
10/14/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session