Contract Pharmacy Details

RELIANT MEDICAL LLC DBA RELIANT HEALTHCA
CAH191315-00 HARDTNER MEDICAL CENTER

Covered Entity Details

Entity Name

HARDTNER MEDICAL CENTER

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH191315-00

Entity Address

1102 N. PINE ROAD
OLLA, LA 71465

Medicare Provider Number

191315

Participating Start Date

4/1/2015

Last Recertification Date

9/24/2024

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

10/15/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Paul G. Mathews, Administrator
(318) 495-3131 Ext: 109

Contract Pharmacy Representative

Reliant Healthcare
Brad Smith, CEO
(318) 322-8326

Signed By Date

10/15/2019

340B Drug Pricing Program Database