Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
CH051030 TCA HEALTH, INC. NFP

Covered Entity Details

Entity Name

TCA HEALTH, INC. NFP

Subdivision Name

THE CLINIC IN ALTGELD, INC.

Type

HRSA-Funded Health Center

340B ID

CH051030

Entity Address

1029 E 130th St
Chicago, IL 60628-6908

Grant Number

H80CS00109

Participating Start Date

10/1/1997

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 02520
6445 CALUMET AVE.
HAMMOND, IN 46324

Pharmacy Comments

Contract Details

Approval Date

10/15/2024

Contract Begin Date

1/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

VERONICA CLARKE, CEO
(773) 995-6300 Ext: 213

Contract Pharmacy Representative

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

Signed By Date

10/15/2024

340B Drug Pricing Program Database