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HOOK-SUPERX, L.L.C.
FQHCLA393B Neighborhood Health Center, INC
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Covered Entity Details
Entity Name
Neighborhood Health Center, INC
Subdivision Name
Fayette County Medical Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA393B
Entity Address
2025 Virginia Avenue
Connersville, IN 47331-2971
Grant Number
LALCS32717
Participating Start Date
1/1/2023
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06647
1515 EAST MAIN STREET
RICHMOND, IN 47374
Pharmacy Comments
Contract Details
Approval Date
10/4/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/3/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Carrie N Miles, CEO
(765) 965-4299
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/3/2022
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