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DIPLOMAT SPECIALTY PHARMACY
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
5/29/2025
Pharmacy Details
Pharmacy Name
DIPLOMAT SPECIALTY PHARMACY
Pharmacy Address
4100 S SAGINAW ST
STE D
FLINT, MI 48507-2683
Pharmacy Comments
04/09/2012 update address and name (added suite)
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
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
10/12/2020
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