Contract Pharmacy Details

PRIME THERAPEUTICS SPECIALTY PHARMACY LL
HV01710B 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

Uptown Clinic

Type

Ryan White Part C

340B ID

HV01710B

Entity Address

2801 Lemmon Ave
Suite 400
Dallas, TX 75204

Grant Number

H76HA01710

Participating Start Date

4/1/2019

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

PRIME THERAPEUTICS SPECIALTY PHARMACY LL

Pharmacy Address

ALLIANCERX WALGREENS PRIME #16568
2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDO, FL 32819-9992

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

10/6/2022
Pharmacy closed

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