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HOOK-SUPERX, L.L.C.
FQHCLA419C CENTERSTONE HEALTH SERVICES INC
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Covered Entity Details
Entity Name
CENTERSTONE HEALTH SERVICES INC
Subdivision Name
Centerstone Health Services - Richmond
Type
Health Center Program Look-Alike
340B ID
FQHCLA419C
Entity Address
831 Dillon Dr STE A
Richmond, IN 47374-8048
Grant Number
LALCS40181
Participating Start Date
4/7/2023
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06636
298 SOUTH WEST 18TH ST.,
RICHMOND, IN 47374
Pharmacy Comments
Contract Details
Approval Date
4/9/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jennifer Harrison, CEO
(812) 350-8249
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/9/2025
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