Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
CH05320AD HealthNet, Inc.

Covered Entity Details

Entity Name

HealthNet, Inc.

Subdivision Name

Julian Center Shelter

Type

HRSA-Funded Health Center

340B ID

CH05320AD

Entity Address

-
Indianapolis, IN 46202-1305

Grant Number

H80CS00114

Participating Start Date

4/1/2016

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06572
1375 WEST 86TH ST.
INDIANAPOLIS, IN 46260

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