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PRISM HEALTH NORTH TEXAS PHARMACY
STD75215 AIDS Arms, Inc.d/b/a Prism Health North Texas
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Covered Entity Details
Entity Name
AIDS Arms, Inc.d/b/a Prism Health North Texas
Subdivision Name
South Dallas Clinic
Type
Sexually Transmitted Diseases
340B ID
STD75215
Entity Address
4922 Spring Ave
Dallas, TX 75210-1359
Grant Number
NH25PS005182
Participating Start Date
4/1/2015
Last Recertification Date
5/14/2024
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
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
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