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RELIANT HEALTHCARE
FP757660 Special Health Resources for Texas, Inc.
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Covered Entity Details
Entity Name
Special Health Resources for Texas, Inc.
Subdivision Name
Jacksonville Care Clinic
Type
Family Planning (Title X only)
340B ID
FP757660
Entity Address
1013 College Avenue
Jacksonville, TX 75766
Grant Number
FPHPA006521
Participating Start Date
1/1/2021
Last Recertification Date
5/8/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
RELIANT HEALTHCARE
Pharmacy Address
RELIANT MEDICAL LLC
4503 TROUP HWY
TYLER, TX 75703
Pharmacy Comments
Contract Details
Approval Date
5/3/2023
Contract Begin Date
6/6/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Shaun'ta Whitehead, CEO
(903) 212-7395
Contract Pharmacy Representative
Reliant Healthcare
Brad Smith, CEO
(318) 322-8326
Signed By Date
5/3/2023
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