Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
CH053092J HEALTHLINC, INC.

Covered Entity Details

Entity Name

HEALTHLINC, INC.

Subdivision Name

HealthLinc Centennial

Type

HRSA-Funded Health Center

340B ID

CH053092J

Entity Address

621 Memorial Dr Ste 402
South Bend, IN 46601-1063

Grant Number

H80CS06662

Participating Start Date

4/1/2019

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06487
2101 EAST IRELAND RD.
SOUTH BEND, IN 46614

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

340B Drug Pricing Program Database