Contract Pharmacy Details

RELIANT MEDICAL LLC DBA RELIANT HEALTHCA
RWIID70112 STD/HIV Program

Covered Entity Details

Entity Name

STD/HIV Program

Subdivision Name

OFFICE OF PUBLIC HEALTH

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID70112

Entity Address

1450 POYDRAS ST.
Suite 2136
NEW ORLEANS, LA 70112

Grant Number

X07HA00018

Participating Start Date

7/1/1998

Last Recertification Date

2/14/2025

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

10/9/2013

Contract Begin Date

1/1/2014

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

HEATHER WEAVER, TAB COORDINATOR
(504) 568-5489

Contract Pharmacy Representative

Jerry Crank, Director of Sales
(510) 587-2660

Signed By Date

10/9/2013

340B Drug Pricing Program Database