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HOOK-SUPERX, L.L.C.
CH053092K HEALTHLINC, INC.
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Covered Entity Details
Entity Name
HEALTHLINC, INC.
Subdivision Name
HealthLinc La Porte
Type
HRSA-Funded Health Center
340B ID
CH053092K
Entity Address
400 Teegarden St
Laporte, IN 46350-3175
Grant Number
H80CS06662
Participating Start Date
1/1/2020
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06483
1407 LINCOLNWAY
LAPORTE, IN 46350
Pharmacy Comments
Contract Details
Approval Date
4/8/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Melissa D Mitchell, CEO
(219) 465-9503
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/8/2024
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