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RELIANT MEDICAL LLC DBA RELIANT HEALTHCA
CHC28363-11 SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
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Covered Entity Details
Entity Name
SPECIAL HEALTH RESOURCES FOR TEXAS, INCORPORATED
Subdivision Name
Integrated Care Clinic
Type
HRSA-Funded Health Center
340B ID
CHC28363-11
Entity Address
1300 North 6th Street
Longview, TX 75601-5567
Grant Number
H80CS28363
Participating Start Date
4/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
RELIANT MEDICAL LLC DBA RELIANT HEALTHCA
Pharmacy Address
1004 N 19TH ST
MONROE, LA 71201-5734
Pharmacy Comments
11/15/10 UPDATED ADDR (WAS 300 N. STANLEY);
Contract Details
Approval Date
4/5/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
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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