Contract Pharmacy Details

CYSTIC FIBROSIS SERVICES, LLC
HV01710A 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 C

340B ID

HV01710A

Entity Address

4922 Spring Ave
Dallas, TX 75210-1359

Grant Number

H76HA01710

Participating Start Date

7/1/2016

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

CYSTIC FIBROSIS SERVICES, LLC

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #16280
10530 JOHN W ELLIOTT DR STE 200
FRISCO, TX 75033

Pharmacy Comments

Contract Details

Approval Date

4/17/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/14/2024
Business decision by covered entity and/or pharmacy

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

4/17/2020

340B Drug Pricing Program Database