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RELIANT MEDICAL LLC DBA RELIANT HEALTHCA
RWII71301 Central Louisiana AIDS Support Services, Inc.
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Covered Entity Details
Entity Name
Central Louisiana AIDS Support Services, Inc.
Subdivision Name
Type
Ryan White Part B
340B ID
RWII71301
Entity Address
1785 Jackson Street
Alexandria, LA 71301
Grant Number
T2-LA
Participating Start Date
7/1/2013
Last Recertification Date
2/12/2025
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
7/3/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ann Lowrey, Director
(318) 442-1010 Ext: 214
Contract Pharmacy Representative
Reliant Healthcare
BRAD SMITH, CEO
(318) 322-8326
Signed By Date
7/3/2013
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