Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
CHC26567-00 MERIDIAN SERVICES CORP

Covered Entity Details

Entity Name

MERIDIAN SERVICES CORP

Subdivision Name

Meridian Health Services

Type

HRSA-Funded Health Center

340B ID

CHC26567-00

Entity Address

240 N Tillotson Ave
Muncie, IN 47304-3988

Grant Number

H80CS26567

Participating Start Date

4/1/2016

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 08657
1725 SALEM STREET
LAFAYETTE, IN 47904

Pharmacy Comments

Contract Details

Approval Date

10/14/2022

Contract Begin Date

1/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Scott Riggs, Chief Financial Officer
(765) 254-5189

Contract Pharmacy Representative

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

Signed By Date

10/14/2022

340B Drug Pricing Program Database