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HOOK-SUPERX, L.L.C.
CHC26567-00 MERIDIAN SERVICES CORP
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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 # 02484
4630 SO. WASHINGTON ST.
MARION, IN 46953
Pharmacy Comments
Contract Details
Approval Date
4/11/2023
Contract Begin Date
7/1/2023
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
4/11/2023
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