Contract Pharmacy Details

RELIANT MEDICAL LLC DBA RELIANT HEALTHCA
HV71202 Pinnacle Family Health, Inc.

Covered Entity Details

Entity Name

Pinnacle Family Health, Inc.

Subdivision Name

Type

Ryan White Part C

340B ID

HV71202

Entity Address

101 Crosley Street
West Monroe, LA 71291-2913

Grant Number

H76HA00696

Participating Start Date

10/1/2004

Last Recertification Date

2/13/2025

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

4/15/2010

Contract Begin Date

4/15/2010

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

RICHARD WOMACK, EXECUTIVE DIRECTOR
(318) 325-1092

Contract Pharmacy Representative

Reliant Healthcare
BRAD SMITH, CEO
(318) 322-8326

Signed By Date

4/8/2010

340B Drug Pricing Program Database