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RWI76104 TARRANT COUNTY PUBLIC HEALTH (Active)
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Main Details
Name
TARRANT COUNTY PUBLIC HEALTH
Subdivision Name
PREVENTIVE MEDICINE CLINIC
Type
Ryan White Part A
340B ID
RWI76104
Grant Number
H89HA00047
Additional Details
Current Program Status
Active
Registration Date
7/1/2004
Participating Start Date
7/1/2004
Participating Approval Date
6/9/2005
Last Recertification Date
3/4/2025
Time Period the Assistance was Received
3/1/2025 - 2/28/2026
Contacts
Authorizing Official
Tarrant County
Amanda Campbell, PH Business Solutions Manager
(817) 321-5320
Primary Contact
Tarrant County
Ty Guy, Analyst
(817) 884-3722
Addresses
Street Address
1101 SOUTH MAIN STREET, SUITE 1500C
FORT WORTH, TX 76104
Billing Address
Tarrant County
100 E. Weatherford
Suite 506
Fort Worth, TX 76196
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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5/20/09 UPDATED MEDICAID NUMBER (WAS 0831497-02); 6/9/06 UPDATED MEDICAID NUMBER (WAS 0831497-01); 5/2006 ID UPDATED FROM RW176104 TO COMPLY WITH NUMBERING CONVENTION
07/22/2010
May 2025
May 2025
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