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HOOK-SUPERX, L.L.C.
FQHCLA361 ADULT AND CHILD HEALTH INC
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Covered Entity Details
Entity Name
ADULT AND CHILD HEALTH INC
Subdivision Name
Adult and Child Health - Irvington
Type
Health Center Program Look-Alike
340B ID
FQHCLA361
Entity Address
5839 E. Washington Street
Indianapolis, IN 46219
Grant Number
LALCS31537
Participating Start Date
4/1/2018
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
HOOK-SUPERX, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06640
265 SO. SCATTERFIELD RD
ANDERSON, IN 46012
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jessica Stembel, Chief Clinical Officer
(317) 494-0739
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2025
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