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WALGREEN CO.
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
5/29/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09647
5201 BELTLINE RD
DALLAS, TX 75254
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John T. Carlo, CEO
(214) 521-5191
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2020
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