Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
STD46208 Brothers United, Inc.

Covered Entity Details

Entity Name

Brothers United, Inc.

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD46208

Entity Address

1712 N. Meridian St.
Suite 200
Indianapolis, IN 46202

Grant Number

6 NU62PS924556-01-03

Participating Start Date

7/1/2019

Last Recertification Date

5/31/2024

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

CVS/PHARMACY # 10903
336 SOUTH DELAWARE ST
INDIANAPOLIS, IN 46204

Pharmacy Comments

Contract Details

Approval Date

1/3/2024

Contract Begin Date

4/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jasmine A Black, Executive Director
(317) 931-0292

Contract Pharmacy Representative

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

Signed By Date

1/3/2024

340B Drug Pricing Program Database