Contract Pharmacy Details

PRISM HEALTH NORTH TEXAS PHARMACY
RWI75208 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

Oak Cliff Clinic

Type

Ryan White Part A

340B ID

RWI75208

Entity Address

219 SUNSET, SUITE 116A
DALLAS, TX 75208-4531

Grant Number

H89HA00014

Participating Start Date

1/1/2002

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