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CVS ALBANY, 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
CVS ALBANY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02430
224 EAST 161ST STREET
BRONX, NY 10451
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
5/17/2022
Pharmacy closed
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
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