Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
CHC17157-02 REGIONAL HEALTH CARE AFFILIATES, INC.

Covered Entity Details

Entity Name

REGIONAL HEALTH CARE AFFILIATES, INC.

Subdivision Name

Regional Health Care Affiliates, Inc. Doing Business As Health First CHC - Clay

Type

HRSA-Funded Health Center

340B ID

CHC17157-02

Entity Address

140 Veterans Memorial Ave.
Clay, KY 42404

Grant Number

H80CS17157

Participating Start Date

10/1/2013

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

CVS/PHARMACY #11114
2800 ENTERPRISE ST STE 5
INDIANAPOLIS, IN 46219-1106

Pharmacy Comments

Contract Details

Approval Date

7/3/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Shelley Renea Gobin, CEO
(270) 667-2535 Ext: 2104

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/3/2024

340B Drug Pricing Program Database