Contract Pharmacy Details

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

Covered Entity Details

Entity Name

Brothers United, Inc.

Subdivision Name

N/A

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

6/3/2025

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