340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HOOK-SUPERX, L.L.C.
CH05311U INDIANA HEALTH CENTERS INCORPORATED
Print
Covered Entity Details
Entity Name
INDIANA HEALTH CENTERS INCORPORATED
Subdivision Name
Oaklawn Psychiatric Center
Type
HRSA-Funded Health Center
340B ID
CH05311U
Entity Address
415 E MADISON ST
SOUTH BEND, IN 46617-2322
Grant Number
H80CS00668
Participating Start Date
7/1/2017
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08631
4403 W. WESTERN AVE.
SOUTH BEND, IN 46619
Pharmacy Comments
Contract Details
Approval Date
1/5/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Agreement registered in error
Contacts
Covered Entity Signing Official
Nicole Meyer, COO
(317) 576-1335 Ext: 4137
Contract Pharmacy Representative
CVS Pharmacies
Christian Reid, 340B Program Director
(401) 770-2118
Signed By Date
1/5/2024
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