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PROCARE PHARMACY, L.L.C.
STD75204 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
Uptown Clinic
Type
Sexually Transmitted Diseases
340B ID
STD75204
Entity Address
2801 Lemmon Ave
Suite 400
Dallas, TX 75204
Grant Number
NH25PS005182
Participating Start Date
7/1/2019
Last Recertification Date
5/14/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2923
3250 HARDEN ST. EXT. SUITE #300
COLUMBIA, SC 29203
Pharmacy Comments
Contract Details
Approval Date
7/16/2020
Contract Begin Date
10/1/2020
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
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/16/2020
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