Contract Pharmacy Details

HOOK-SUPERX, L.L.C.
HV01710C 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 Lawn Health Center

Type

Ryan White Part C

340B ID

HV01710C

Entity Address

2801 Lemmon Ave
Suite 200
Dallas, TX 75204

Grant Number

H76HA01710

Participating Start Date

10/1/2019

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

HOOK-SUPERX, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 06603
5005 EAST 56TH ST.
INDIANAPOLIS, IN 46226

Pharmacy Comments

Contract Details

Approval Date

1/22/2021

Contract Begin Date

4/1/2021

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

1/22/2021

340B Drug Pricing Program Database