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RIVER MEDICAL PHARMACY LLC
CH05320AL HealthNet, Inc.
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Covered Entity Details
Entity Name
HealthNet, Inc.
Subdivision Name
Middle Way House Clinic
Type
HRSA-Funded Health Center
340B ID
CH05320AL
Entity Address
338 S Washington St
Bloomington, IN 47401-3529
Grant Number
H80CS00114
Participating Start Date
1/1/2023
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
RIVER MEDICAL PHARMACY LLC
Pharmacy Address
4752 RESEARCH DR
SAN ANTONIO, TX 78240-5002
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Varon Edward Cantrell, Chief Medical Officer
(317) 957-2015
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
4/15/2024
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