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PRISM HEALTH NORTH TEXAS PHARMACY #2
STD752041 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
Oak Lawn Health Center
Type
Sexually Transmitted Diseases
340B ID
STD752041
Entity Address
2801 Lemmon Ave
Suite 200
Dallas, TX 75204
Grant Number
NH25PS005182
Participating Start Date
10/1/2019
Last Recertification Date
5/14/2024
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
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