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RELIANT HEALTHCARE
HV75604 SPECIAL HEALTH RESOURCES FOR TEXAS, INC.
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Covered Entity Details
Entity Name
SPECIAL HEALTH RESOURCES FOR TEXAS, INC.
Subdivision Name
Jim Meyer Comprehensive Health Center
Type
Ryan White Part C
340B ID
HV75604
Entity Address
410 North Fourth Street
LONGVIEW, TX 75601-6511
Grant Number
H76HA01705
Participating Start Date
10/1/2004
Last Recertification Date
2/17/2025
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
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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