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RANDALLS FOOD AND DRUGS LP
STD75215 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
South Dallas Clinic
Type
Sexually Transmitted Diseases
340B ID
STD75215
Entity Address
4922 Spring Ave
Dallas, TX 75210-1359
Grant Number
NH25PS005182
Participating Start Date
4/1/2015
Last Recertification Date
5/14/2024
Pharmacy Details
Pharmacy Name
RANDALLS FOOD AND DRUGS LP
Pharmacy Address
TOM THUMB PHARMACY #3296
2380 N FIELD ST
DALLAS, TX 75201
Pharmacy Comments
Contract Details
Approval Date
10/12/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John T. Carlo, CEO
(214) 521-5191
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
10/12/2020
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