Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
CH053200 HealthNet, Inc.

Covered Entity Details

Entity Name

HealthNet, Inc.

Subdivision Name

HealthNet Administration/HealthNet Specialty Care at Barrington

Type

HRSA-Funded Health Center

340B ID

CH053200

Entity Address

3403 E Raymond St
Indianapolis, IN 46203

Grant Number

H80CS00114

Participating Start Date

12/1/1992

Last Recertification Date

2/26/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06739
860 WEST MORGAN STREET
SPENCER, IN 47460

Pharmacy Comments

Contract Details

Approval Date

1/11/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Richard Reifenberg, Chief Medical Officer
(317) 957-2028

Contract Pharmacy Representative

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

Signed By Date

1/11/2022

340B Drug Pricing Program Database