340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HOOK-SUPERX, L.L.C.
CH05320N HealthNet, Inc.
Print
Covered Entity Details
Entity Name
HealthNet, Inc.
Subdivision Name
Northeast Health Center
Type
HRSA-Funded Health Center
340B ID
CH05320N
Entity Address
3908 Meadows Dr
Indianapolis, IN 46205-3114
Grant Number
H80CS00114
Participating Start Date
1/1/2014
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06612
5110 E. 38TH ST.
INDIANAPOLIS, IN 46218
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/20/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Varon Edward Cantrell, Chief Medical Officer
(317) 957-2015
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/13/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session