Contract Pharmacy Details

PRISM HEALTH NORTH TEXAS PHARMACY #2
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

PRISM HEALTH NORTH TEXAS PHARMACY #2

Pharmacy Address

219 SUNSET AVE STE 116A, CONFERENCE 1A
DALLAS, TX 75208-4531

Pharmacy Comments

Contract Details

Approval Date

7/7/2020

Contract Begin Date

10/1/2020

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

7/7/2020

340B Drug Pricing Program Database