Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
CHC35351-00 WELL CARE COMMUNITY HEALTH, INC.

Covered Entity Details

Entity Name

WELL CARE COMMUNITY HEALTH, INC.

Subdivision Name

Well Care Community Health, Inc.

Type

HRSA-Funded Health Center

340B ID

CHC35351-00

Entity Address

203 E Main St
Richmond, IN 47374-4208

Grant Number

H80CS35351

Participating Start Date

10/1/2020

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06756
201 EAST TIPTON STREET
SEYMOUR, IN 47274

Pharmacy Comments

Contract Details

Approval Date

10/3/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Eric Coulter, Chief Executive Officer
(765) 973-9369

Contract Pharmacy Representative

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

Signed By Date

10/3/2023

340B Drug Pricing Program Database