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RELIANT MEDICAL LLC DBA RELIANT HEALTHCA
CH061335AD ST. CHARLES COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
ST. CHARLES COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Access Health Louisiana Primary Care at the Pythian
Type
HRSA-Funded Health Center
340B ID
CH061335AD
Entity Address
234 Loyola Avenue, Fl 3
New Orleans, LA 70112
Grant Number
H80CS00867
Participating Start Date
7/1/2018
Last Recertification Date
2/26/2025
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
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARK F. KEISER, CEO
(504) 575-3746
Contract Pharmacy Representative
Reliant Healthcare
Brad Smith, CEO
(318) 322-8326
Signed By Date
10/14/2019
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