340B Drug Pricing Program Database


FQHCLA471E AIDS ARMS INC (Active) - information as of 4/27/2025 12:51:29 AM

Main Details
AIDS ARMS INC
Prism Health North Texas at Vickery Meadow Dental Health Center
Health Center Program Look-Alike
BPS-LAL-038984
FQHCLA471E
LALCS53449


Additional Details
Active
10/1/2024
1/1/2025
10/2/2024
2/18/2025

Contacts

AIDS Arms, Inc.
John T. Carlo, CEO
(214) 521-5191

AIDS Arms, Inc.
Sara Dingwall, Interim Pharmacy Director
(772) 202-8205

Addresses

8224 Park Ln, Ste 125
Dallas, TX 75231-6020

AIDS ARMS, Inc. dba Prism Health North Texas
3900 Junius Street
300
Dallas, TX 75246


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Same as Street Address
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
FQHCLA471ActiveBPS-LAL-038976AIDS ARMS INCPrism Health North Texas at Worth Street Health Center4004 Worth Street STE 100 DallasTX
FQHCLA471AActiveBPS-LAL-038979AIDS ARMS INCPrism Health North Texas at Oak Lawn Health Center2801 Lemmon Ave STE 200 DallasTX
FQHCLA471BActiveBPS-LAL-038985AIDS ARMS INCPrism Health North Texas at UPG Health Center2801 Lemmon Ave, Ste 400 DallasTX
FQHCLA471CActiveBPS-LAL-038978AIDS ARMS INCPrism Health North Texas at South Dallas Health Center4922 Spring Ave DallasTX
FQHCLA471DActiveBPS-LAL-038982AIDS ARMS INCPrism Health North Texas at Oak Cliff Health Center219 Sunset Ave Suite 116-A DallasTX
FQHCLA471EActiveBPS-LAL-038984AIDS ARMS INCPrism Health North Texas at Vickery Meadow Dental Health Center8224 Park Ln, Ste 125 DallasTX
FQHCLA471FActiveBPS-LAL-038983AIDS ARMS INCPrism Health North Texas at East Dallas Dental Health Center3910 Gaston Ave, Ste 175 DallasTX
FQHCLA471GActiveBPS-LAL-038980AIDS ARMS INCPrism Health North Texas at Farmers Branch Dental Health Center13551 Dennis Ln Farmers BranchTX
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
FQHCLA471ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201001/01/2025  
FQHCLA471ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884901/01/2025  
FQHCLA471ADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101 		ORLANDOFL3280907/01/2025  
FQHCLA471AVITA PHARMACY 1028340B PARTNERS PHARMACY-DALLAS LLC DBA AV 750 FORT WORTH AVE STE H100
DALLASTX75208-181101/01/2025  
FQHCLA471AVITA PHARMACY 1040AVITA DRUGS, LLC D/B/A AVITA PHARMACY 10 6100 CORPORATE BLVD STE 250
BATON ROUGELA7080801/01/2025  
FQHCLA471BIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526101/01/2025  
FQHCLA471CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361407/01/2025  
FQHCLA471CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005607/01/2025  
FQHCLA471CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621907/01/2025  
FQHCLA471CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175707/01/2025  
FQHCLA471CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808307/01/2025  
FQHCLA471CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700407/01/2025  
FQHCLA471CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761707/01/2025  
FQHCLA471CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813307/01/2025  
FQHCLA471CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237407/01/2025  
FQHCLA471CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911907/01/2025  
FQHCLA471CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870607/01/2025  
FQHCLA471CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005607/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 08342 1305 WEST BELTLINE RD.
DESOTOTX7511501/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10271 1510 W. HICKORY STREET
DENTONTX7620101/01/2025  
FQHCLA471CVS PHARMACY, INC.CVS PHARMACY # 16892 1400 PRECINCT LINE RD
HURSTTX7605301/01/2025  
FQHCLA471CVS PHARMACY, INC.CVS/PHARMACY # 10665 1555 EAST RENNER RD.
RICHARDSONTX7508201/01/2025  
FQHCLA471CVS PHARMACY, INC.CVS PHARMACY # 16364 9440 MARSH LN
DALLASTX7522001/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10670 4930 MAPLE AVE.
DALLASTX7523501/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10324 6420 GASTON AVENUE
DALLASTX7521401/01/2025  
FQHCLA471CVS PHARMACY, INC.CVSPHARMACY # 17318 5270 S STATE HWY 360
GRAND PRAIRIETX7505201/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10634 2350 N. FITZHUGH AVENUE
DALLASTX7520401/01/2025  
FQHCLA471CVS PHARMACY, INC.CVS PHARMACY # 16312 2417 N HASKELL AVE
DALLASTX7520401/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 08440 4205 N. JOSEY LN.
CARROLLTONTX7501001/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10576 3802 E BROAD STREET
MANSFIELDTX7606301/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #11389 8700 N BELT LINE RD
IRVINGTX75063-602501/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10909 6474 E. NORTHWEST HWY
DALLASTX7521401/01/2025  
FQHCLA471CVS PHARMACY, INC.CVS PHARMACY # 16707 1401 W GLADE RD
EULESSTX7603901/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #11065 9215 MIDWAY ROAD
DALLASTX7522001/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10487 1305 NORTH HIGHWAY 377
ROANOKETX7626201/01/2025  
FQHCLA471CVS PHARMACY, INC.CVS PHARMACY # 16419 7845 N MACARTHUR BLVD
IRVINGTX7506301/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10880 8580 N MACARTHUR BLVD
IRVINGTX7506301/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #11015 18081 PRESTON ROAD
DALLASTX7525201/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10351 3133 E. LEMMON AVENUE
DALLASTX7520401/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10948 108 W. DAVIS ST.
DALLASTX7520801/01/2025  
FQHCLA471CVS PHARMACY, INC.CVS/PHARMACY #10910 3030 SYLVAN AVE
DALLASTX7521201/01/2025  
FQHCLA471CVS PHARMACY, INC.CVS PHARMACY # 16003 13131 MONTFORT DR
DALLASTX7524001/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 08345 5195 LAKE RIDGE PKWY.
GRAND PRAIRIETX7505201/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY # 10581 12740 ELDORADO PKWY.
FRISCOTX7503501/01/2025  
FQHCLA471CVS PHARMACY, INC.CVS PHARMACY # 17401 2025 N CENTRAL EXPY
MCKINNEYTX7507001/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10523 270 STONEBROOK PKWY
FRISCOTX7503601/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #10758 2501 N FIELD STREET
DALLASTX7520101/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY # 10056 5050 SOUTH LANCASTER RD
DALLASTX7521601/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA CVS/PHARMACY #11323 1115 8TH AVENUE
FORT WORTHTX7610401/01/2025  
FQHCLA471CVS PHARMACY, INC.CVS PHARMACY # 16970 3730 BELT LINE RD
ADDISONTX7500101/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 05260 3401 W. WALNUT HILL LN.
IRVINGTX7503807/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07440 17410 MARSH LN
DALLASTX7528707/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07149 2899 FOREST LANE
DALLASTX7523407/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06963 7102 CAMPBELL RD
DALLASTX7524807/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07453 2200 COIT RD.
PLANOTX7507507/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 04794 5900 W. PLEASANT RIDGE RD.
ARLINGTONTX7601607/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07413 10014 GARLAND RD
DALLASTX7521807/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07431 3430 LAKEVIEW PKWY
ROWLETTTX7508807/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 05963 15105 PRESTON RD.
DALLASTX7524807/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 02979 6120 E. MOCKINGBIRD LN.
DALLASTX7521407/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07664 1235 S BUCKNER BLVD
DALLASTX7521707/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07719 2900 W ANDERSON LN STE 10
AUSTINTX7875707/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07237 3614 CAMP BOWIE BLVD.
FORT WORTHTX7610707/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07462 601 N INDUSTRIAL BLVD
BEDFORDTX7602107/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07490 507 CLARKSVILLE ST.
PARISTX7546007/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 00334 8995 STACY RD.
MCKINNEYTX7507007/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 03707 6151 MATLOCK RD.
ARLINGTONTX7601807/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06967 1425 E BUCKINGHAM RD
RICHARDSONTX7508107/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 00296 2420 W. WHEATLAND RD.
DALLASTX7523707/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07412 5370 W LOVERS LN STE 310
DALLASTX7520907/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 05314 1411 MAIN ST.
DALLASTX7520207/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06806 5010 WESLEY ST
GREENVILLETX7540107/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07675 105 HARRIS AVE
RED OAKTX7515407/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07715 410 W ROCHELLE RD
IRVINGTX7506207/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 02876 201 S. PRESTON RD.
PROSPERTX7507807/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07801 6000 BRYANT IRVIN RD
FORT WORTHTX7613207/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07456 2427 W JEFFERSON BLVD
DALLASTX7521107/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07702 603 S CEDAR RIDGE DR
DUNCANVILLETX7513707/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 04625 525 W. PARKER RD.
PLANOTX7502307/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07624 1800 BROWN BLVD
ARLINGTONTX7600607/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06824 8024 WALNUT HILL LN.
DALLASTX7523107/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 05962 3200 TEASLEY LN.
DENTONTX7621007/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 00015 5500 N. MACARTHUR
IRVINGTX7503807/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06803 2222 N STORY RD
IRVINGTX7506207/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 02991 6431 MCCART AVE.
FORT WORTHTX7613307/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 01104 1540 E. MAIN ST.
ALLENTX7500207/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07748 10003 MARSH LN
DALLASTX7522907/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07623 4610 FRANKFORD RD
DALLASTX7528707/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 03900 14041 NOEL RD.
DALLASTX7524007/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 03134 801 N. TARRANT PKWY.
KELLERTX7624807/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 02976 6401 PRECINCT LINE RD.
NORTH RICHLAND HILLSTX7618207/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06864 701 FERRIS AVE
WAXAHACHIETX7516507/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06856 116 W. UNIVERSITY DR
DENTONTX7620107/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07603 1301 N. SAGINAW BLVD.
SAGINAWTX7617907/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06965 7203 SKILLMAN ST.
DALLASTX7523107/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 08330 6320 RUFE SNOW DR
NORTH RICHLAND HILLSTX7618007/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06779 3012 MOCKINGBIRD LN
DALLASTX7520507/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07640 1225 N BLUEGROVE RD
LANCASTERTX7514607/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07156 605 W. CAMPBELL RD.
RICHARDSONTX7508007/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06775 701 E MAIN ST
GRAND PRAIRIETX7505007/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06777 4207 LEMMON AVE.
DALLASTX7521907/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 05259 2129 E. BELT LINE RD.
RICHARDSONTX7508107/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07288 11661 PRESTON RD. STE 218
DALLASTX7523007/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07740 10455 N CENTRAL EXPY
DALLASTX7523107/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 05894 13033 COIT RD.
DALLASTX7524007/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07417 11820 ELAM RD
BALCH SPRINGSTX7518007/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06781 2323 W ILLINOIS AVE
DALLASTX7522407/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 04272 4202 ROSS AVE.
DALLASTX7520407/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07672 3798 FOREST LN
DALLASTX7524407/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07742 5659 LEMMON AVE
DALLASTX7520907/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 04985 8335 WESTCHESTER DR., SUITE 140
DALLASTX7522507/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07430 8555 FERGUSON RD
DALLASTX7522807/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07732 605 W. ENNIS AVE.
ENNISTX7511907/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06966 6004 SAMUELL BLVD
DALLASTX7522807/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 07491 385 E BELT LINE RD
CEDAR HILLTX7510407/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 03180 2200 MATLOCK RD.
MANSFIELDTX7606307/01/2025  
FQHCLA471CVS PHARMACY, INC.DBA: CVS/PHARMACY # 06960 2142 N JOSEY LN
CARROLLTONTX7500607/01/2025  
FQHCLA471CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502807/01/2025  
FQHCLA471EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313401/01/2025  
FQHCLA471EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607501/01/2025  
FQHCLA471EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801601/01/2025  
FQHCLA471GARFIELD BEACH CVS, L.L.C.DBA: CVS/PHARMACY # 09804 425 S. SUNRISE WAY
PALM SPRINGSCA9226201/01/2025  
FQHCLA471KROGER PHARMACY7505 N. MAC ARTHUR BLVD.
IRVINGTX7506301/01/2025  
FQHCLA471KROGER PHARMACY #4023612 N BELTLINE ROAD
IRVINGTX7506201/01/2025  
FQHCLA471KROGER PHARMACY #5094901 MAPLE AVE
DALLASTX7523501/01/2025  
FQHCLA471KROGER PHARMACY #5185665 E MOCKINGBIRD
DALLASTX7520601/01/2025  
FQHCLA471KROGER PHARMACY #5284142 CEDAR SPRINGS
DALLASTX7521901/01/2025  
FQHCLA471KROGER PHARMACY #5294241 CAPITOL AVE
DALLASTX7520401/01/2025  
FQHCLA471KROGER PHARMACY #5591406 WEST WALNUT
GARLANDTX7504201/01/2025  
FQHCLA471KROGER PHARMACY #5672901 LAKE FOREST DRIVE
MCKINNEYTX7507201/01/2025  
FQHCLA471KROGER PHARMACY #579500 MARKETPLACE BLVD
FORNEYTX7512601/01/2025  
FQHCLA471KROGER PHARMACY #5873939 FRANKFORD ROAD
DALLASTX7528701/01/2025  
FQHCLA471KROGER PHARMACY #68917194 PRESTON ROAD
DALLASTX7524801/01/2025  
FQHCLA471KROGER PHARMACY #8703770 BELT LINE ROAD
ADDISONTX7500101/01/2025  
FQHCLA471LONGS DRUGS OF LEXINGTOND/B/A AVITA PHARMACY 1051 1216 W MAIN ST
STE D 		LEXINGTONSC29072-245301/01/2025  
FQHCLA471MISSISSIPPI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 05573 401 HWY 12 EAST
STARKVILLEMS3975907/01/2025  
FQHCLA471MISSOURI CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08543 1914 SWIFT
N. KANSAS CITYMO6411601/01/2025  
FQHCLA471OPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850701/01/2025  
FQHCLA471OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713001/01/2025  
FQHCLA471OPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729801/01/2025  
FQHCLA471PRISM HEALTH NORTH TEXAS PHARMACYEHP TEXAS LLC 4907 SPRING AVE STE 101
DALLASTX75210-136007/01/2025  
FQHCLA471PRISM HEALTH NORTH TEXAS PHARMACY #2219 SUNSET AVE STE 116A, CONFERENCE 1A
DALLASTX75208-453107/01/2025  
FQHCLA471PRISM HEALTH NORTH TEXAS PHARMACY #32801 LEMMON AVE STE 100
DALLASTX75204-239607/01/2025  
FQHCLA471PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514607/01/2025  
FQHCLA471PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920307/01/2025  
FQHCLA471PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523307/01/2025  
FQHCLA471PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2751 426 S. HENDERSON STREET
FORT WORTHTX7610407/01/2025  
FQHCLA471RANDALLS FOOD AND DRUGS LPTOM THUMB PHARMACY #3296 2380 N FIELD ST
DALLASTX7520101/01/2025  
FQHCLA471RANDALLS FOOD AND DRUGS LPTOM THUMB PHARMACY #2544 10455 N. CENTRAL EXPWY
DALLASTX7523101/01/2025  
FQHCLA471RANDALLS FOOD AND DRUGS LPTOM THUMB PHARMACY #3614 315 SOUTH HAMPTON
DALLASTX7520801/01/2025  
FQHCLA471RANDALLS FOOD AND DRUGS LPTOM THUMB PHARMACY #2990 7117 INWOOD
DALLASTX7520901/01/2025  
FQHCLA471RANDALLS FOOD AND DRUGS LPTOM THUMB PHARMACY #1540 3757 FOREST LN
DALLASTX7523401/01/2025  
FQHCLA471RANDALLS FOOD AND DRUGS LPTOM THUMB PHARMACY #3563 633 WHEATLAND RD
DUNCANVILLETX7511601/01/2025  
FQHCLA471RANDALLS FOOD AND DRUGS LPTOM THUMB PHARMACY #2642 5809 EAST LOVERS LANE
DALLASTX7520601/01/2025  
FQHCLA471RIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500201/01/2025  
FQHCLA471WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #16538 7859 WALNUT HILL LN STE 110
DALLASTX7523001/01/2025  
FQHCLA471WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #15318 3826 CEDAR SPRINGS RD
DALLASTX7521901/01/2025  
FQHCLA471WALGREEN CO.DBA: WALGREENS # 04203 438 W. ILLINOIS AVE.
DALLASTX7522401/01/2025  
FQHCLA471WALGREEN CO.DBA: WALGREENS # 05093 1306 N BECKLEY AVE
DALLASTX7520301/01/2025  
FQHCLA471WALGREEN CO.COMMUNITY, A WALGREENS PHARMACY #21375 3910 GASTON AVE STE 125
DALLASTX7524601/01/2025  
FQHCLA471WALGREEN CO.DBA: WALGREENS # 07334 5001 ROSS AVE
DALLASTX75206-770601/01/2025  
FQHCLA471WALGREEN CO.DBA: WALGREENS # 04013 18207 MIDWAY ROAD
DALLASTX7528701/01/2025  
FQHCLA471WALGREEN CO.DBA: WALGREENS # 09647 5201 BELTLINE RD
DALLASTX7525401/01/2025  
FQHCLA471WALGREEN CO.DBA: WALGREENS # 06660 5742 E MOCKINGBIRD LANE
DALLASTX7520601/01/2025  
FQHCLA471WALGREEN CO.DBA: WALGREENS # 03879 3732 W NORTHWEST HWY
DALLASTX7522001/01/2025  
FQHCLA471WALGREEN CO.DBA: WALGREENS # 05092 3418 MCKINNEY AVE
DALLASTX7520401/01/2025  
FQHCLA471WALGREEN CO.DBA: WALGREENS #13930 11700 PRESTON RD.
SUITE 703 		DALLASTX7523001/01/2025  
FQHCLA471WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #21319 2515 INWOOD RD STE 113
DALLASTX7523501/01/2025  
FQHCLA471WALGREEN CO.DBA: WALGREENS # 07839 3802 CEDAR SPRINGS ROAD
DALLASTX7521901/01/2025  
FQHCLA471Walgreens #21373Walgreens Central Fill #21373 4100 Dale Earnhardt Way
STE 200 		NorthlakeTX7626201/01/2025  
FQHCLA471WALGREENS MAIL SERVICE, LLCWALGREENS MAIL SERVICE #03397 8350 S RIVER PARKWAY
TEMPEAZ8528401/01/2025  
FQHCLA471WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527501/01/2025  
FQHCLA471WALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503301/01/2025  
FQHCLA471WALGREENS.COM, INC.DBA: WALGREENS 2225 S. PRICE ROAD
CHANDLERAZ8528601/01/2025  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification 2/18/2025 5:51:35 PM2/18/2025 5:51 PM
DetailsEntity SubnameUpdateChange RequestVickery Meadow Dental Health CenterPrism Health North Texas at Vickery Meadow Dental Health Center1/15/2025 9:58 AM
DetailsStateUpdate ApprovedActive1/1/2025 12:01 AM
ContactsSigned ByInsertNew Registration Carlo, John T. CEO AIDS Arms, Inc. 214521519110/2/2024 8:32 AM
Details340B IDUpdateNew Registration FQHCLA471E10/2/2024 8:32 AM
DatesParticipating Approval DateUpdateNew Registration 10/2/2024 8:32:22 AM10/2/2024 8:32 AM
DetailsStateUpdateNew RegistrationPendingApproved10/2/2024 8:32 AM
DatesSigned By DateUpdateNew Registration 10/1/2024 5:17:39 PM10/2/2024 8:32 AM
DatesStart DateUpdateNew Registration 1/1/2025 12:00:00 AM10/2/2024 8:32 AM
AddressesMain AddressInsertNew Registration  8224 Park Ln, Ste 125 Dallas, TX 75231-602010/1/2024 3:52 PM
AddressesBilling AddressInsertNew Registration AIDS ARMS, Inc. dba Prism Health North Texas 3900 Junius Street 300 Dallas, TX 7524610/1/2024 3:52 PM
ContactsAuthorizing OfficialInsertNew Registration Carlo, John T. CEO AIDS Arms, Inc. 214521519110/1/2024 3:52 PM
ContactsPrimary ContactInsertNew Registration Dingwall, Sara Interim Pharmacy Director AIDS Arms, Inc. 772202820510/1/2024 3:52 PM
DetailsAssistance Received From DateInsertNew Registration  10/1/2024 3:52 PM
DetailsAssistance Received To DateInsertNew Registration  10/1/2024 3:52 PM
DetailsLast Recertification DateInsertNew Registration  10/1/2024 3:52 PM
DetailsGrant NumberInsertNew Registration LALCS5344910/1/2024 3:52 PM
Details340B IDInsertNew Registration  10/1/2024 3:52 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  10/1/2024 3:52 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  10/1/2024 3:52 PM
DetailsMedicare Provider NumberInsertNew Registration  10/1/2024 3:52 PM
DetailsEntity NameInsertNew Registration AIDS ARMS INC10/1/2024 3:52 PM
DetailsNOFO NumberInsertNew Registration  10/1/2024 3:52 PM
DetailsProgram CodeInsertNew Registration FQHCLA10/1/2024 3:52 PM
DetailsEntity SubnameInsertNew Registration Vickery Meadow Dental Health Center10/1/2024 3:52 PM
DatesParticipating Approval DateInsertNew Registration  10/1/2024 3:52 PM
DetailsStateInsertNew Registration Pending10/1/2024 3:52 PM
DatesRegistration DateInsertNew Registration 10/1/2024 3:52:34 PM10/1/2024 3:52 PM
DatesSigned By DateInsertNew Registration  10/1/2024 3:52 PM
DatesStart DateInsertNew Registration  10/1/2024 3:52 PM
TerminationsTermination CommentsInsertNew Registration  10/1/2024 3:52 PM
TerminationsTermination DateInsertNew Registration  10/1/2024 3:52 PM
TerminationsTermination Effective DateInsertNew Registration  10/1/2024 3:52 PM
TerminationsTermination ReasonInsertNew Registration  10/1/2024 3:52 PM