Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
CAH181319-00 BRECKINRIDGE HEALTH, INC.

Covered Entity Details

Entity Name

BRECKINRIDGE HEALTH, INC.

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH181319-00

Entity Address

1011 OLD HIGHWAY 60
HARDINSBURG, KY 40143

Medicare Provider Number

181319

Participating Start Date

7/1/2011

Last Recertification Date

8/26/2024

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06260
225 12TH ST.
TELL CITY, IN 47586

Pharmacy Comments

Contract Details

Approval Date

7/5/2022

Contract Begin Date

7/11/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Amy Arndell, Chief Financial Officer
(270) 756-6655

Contract Pharmacy Representative

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

Signed By Date

7/5/2022

340B Drug Pricing Program Database