Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
CH05320N HealthNet, Inc.

Covered Entity Details

Entity Name

HealthNet, Inc.

Subdivision Name

Northeast Health Center

Type

HRSA-Funded Health Center

340B ID

CH05320N

Entity Address

3908 Meadows Dr
Indianapolis, IN 46205-3114

Grant Number

H80CS00114

Participating Start Date

1/1/2014

Last Recertification Date

2/25/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06573
2330 EAST 46TH ST.
INDIANAPOLIS, IN 46205

Pharmacy Comments

Contract Details

Approval Date

4/2/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Varon Edward Cantrell, Chief Medical Officer
(317) 957-2015

Contract Pharmacy Representative

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

Signed By Date

4/2/2025

340B Drug Pricing Program Database