Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
CAH151329-00 MARGARET MARY COMMUNITY HOSPITAL, INC.

Covered Entity Details

Entity Name

MARGARET MARY COMMUNITY HOSPITAL, INC.

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH151329-00

Entity Address

321 MITCHELL AVE
BATESVILLE, IN 47006-0226

Medicare Provider Number

151329

Participating Start Date

9/28/2010

Last Recertification Date

8/27/2024

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06787
907 STATE ROAD 229
BATESVILLE, IN 47006

Pharmacy Comments

Contract Details

Approval Date

7/20/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

BRIAN DAEGER, CFO
(812) 933-5135

Contract Pharmacy Representative

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

Signed By Date

7/20/2016

340B Drug Pricing Program Database