Contract Pharmacy Details

RANDALLS FOOD AND DRUGS LP
STD75208 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

Oak Cliff Clinic

Type

Sexually Transmitted Diseases

340B ID

STD75208

Entity Address

219 Sunset Ave
Suite 116-A
Dallas, TX 75208

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 #2990
7117 INWOOD
DALLAS, TX 75209

Pharmacy Comments

Contract Details

Approval Date

10/12/2020

Contract Begin Date

1/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/10/2021
Business decision by covered entity and/or pharmacy

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

340B Drug Pricing Program Database