340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HOOK-SUPERX, L.L.C.
FQHCLA419A Centerstone Health Services, Inc.
Print
Covered Entity Details
Entity Name
Centerstone Health Services, Inc.
Subdivision Name
Centerstone Health Services
Type
Health Center Program Look-Alike
340B ID
FQHCLA419A
Entity Address
645 S Rogers St
Bloomington, IN 47403-2353
Grant Number
LALCS40181
Participating Start Date
4/1/2021
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06703
789 STATE ROAD 39 BY-PASS
MARTINSVILLE, IN 46151
Pharmacy Comments
Contract Details
Approval Date
10/16/2021
Contract Begin Date
10/25/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert Siegmann, Executive Director
(812) 344-4935
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2021
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