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HOOK-SUPERX, L.L.C.
CH05320A HealthNet, Inc.
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Covered Entity Details
Entity Name
HealthNet, Inc.
Subdivision Name
Barrington Health Center
Type
HRSA-Funded Health Center
340B ID
CH05320A
Entity Address
3401 E Raymond St
Indianapolis, IN 46203-4744
Grant Number
H80CS00114
Participating Start Date
10/1/1996
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06583
1715 MAIN STREET
BEECH GROVE, IN 46107
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
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