Contract Pharmacy Details

PRISM HEALTH NORTH TEXAS PHARMACY
RW424837A AIDS ARMS, INC. d/b/a/ Prism Health North Texas

Covered Entity Details

Entity Name

AIDS ARMS, INC. d/b/a/ Prism Health North Texas

Subdivision Name

South Dallas Clinic

Type

Ryan White Part D

340B ID

RW424837A

Entity Address

4922 Spring Ave
DALLAS, TX 75210-1359

Grant Number

H12HA24837

Participating Start Date

4/1/2013

Last Recertification Date

2/10/2022

Entity Termination Date

10/1/2022

Pharmacy Details

Pharmacy Name

PRISM HEALTH NORTH TEXAS PHARMACY

Pharmacy Address

EHP TEXAS LLC
4907 SPRING AVE STE 101
DALLAS, TX 75210-1360

Pharmacy Comments

Contract Details

Approval Date

7/2/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/10/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

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

Contract Pharmacy Representative

Equitas Health
Nick Saltman, Interim Chief Pharmacy Officer
(614) 987-5621

Signed By Date

7/2/2019

340B Drug Pricing Program Database