Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
RWI46208 Brothers United, Inc.

Covered Entity Details

Entity Name

Brothers United, Inc.

Subdivision Name

Type

Ryan White Part A

340B ID

RWI46208

Entity Address

1712 North Meridian St.
Suite 200
Indianapolis, IN 46202

Grant Number

H89HA11463

Participating Start Date

1/1/2017

Last Recertification Date

3/10/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

CVS PHARMACY # 16968
1300 E 86TH ST STE 35
INDIANAPOLIS, IN 46240

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