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HOOK-SUPERX, L.L.C.
FQHCLA354H ASPIRE HEALTH CENTER
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Covered Entity Details
Entity Name
ASPIRE HEALTH CENTER
Subdivision Name
Aspire Indiana Health - DeHaven
Type
Health Center Program Look-Alike
340B ID
FQHCLA354H
Entity Address
2020 Brown St
Anderson, IN 46016-4218
Grant Number
LALCS31260
Participating Start Date
7/1/2019
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06638
2419 NICHOL AVE
ANDERSON, IN 46016
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin Gregory Sheward, Vice President, Strategy & Business Development
(317) 587-0537
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/12/2023
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