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MEDICAL PLAZA PHARMACY
RWII68 SPECIAL HEALTH RESOURCES FOR TEXAS, INC.
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Covered Entity Details
Entity Name
SPECIAL HEALTH RESOURCES FOR TEXAS, INC.
Subdivision Name
Longview Care Clinic
Type
Ryan White Part B
340B ID
RWII68
Entity Address
409 N. 6th Street
LONGVIEW, TX 78702
Grant Number
X07HA00054
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MEDICAL PLAZA PHARMACY
Pharmacy Address
615 N 3RD ST STE 1
LONGVIEW, TX 75601
Pharmacy Comments
Contract Details
Approval Date
10/3/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carlton Smith, CFO
(903) 212-7804 Ext: 7804
Contract Pharmacy Representative
Medical Plaza Pharmacy
Don Novak, Medical Plaza Pharmacy
(903) 757-3477
Signed By Date
10/3/2014
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