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RELIANT HEALTHCARE
CHC28363-06 SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
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Covered Entity Details
Entity Name
SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
Subdivision Name
Jacksonville Care Clinic
Type
HRSA-Funded Health Center
340B ID
CHC28363-06
Entity Address
1011 College Street
Jacksonville, TX 75766-3307
Grant Number
H80CS28363
Participating Start Date
4/1/2019
Last Recertification Date
2/7/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
RELIANT HEALTHCARE
Pharmacy Address
RELIANT MEDICAL LLC
4315 TEXAS BLVD
TEXARKANA, TX 75503
Pharmacy Comments
Contract Details
Approval Date
4/5/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kim Nesvig, CEO
(903) 212-7811 Ext: 7811
Contract Pharmacy Representative
Reliant Healthcare
Brad Smith, CEO
(318) 322-8326
Signed By Date
4/5/2019
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