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HOOK-SUPERX, L.L.C.
CH05848D NEIGHBORHOOD HEALTH CLINICS
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Covered Entity Details
Entity Name
NEIGHBORHOOD HEALTH CLINICS
Subdivision Name
Neighborhood Health Family Medicine Center
Type
HRSA-Funded Health Center
340B ID
CH05848D
Entity Address
750 Broadway STE 350
Fort Wayne, IN 46802-1412
Grant Number
H80CS00548
Participating Start Date
7/1/2024
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06520
3918 SOUTH CALHOUN ST.
FORT WAYNE, IN 46807
Pharmacy Comments
Contract Details
Approval Date
1/10/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Angela Zaegel, CEO
(260) 458-2641 Ext: 3634
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/10/2025
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