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GENOA HEALTHCARE LLC
HV01710D 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
Worth Street
Type
Ryan White Part C
340B ID
HV01710D
Entity Address
4004 Worth Street
Suite 100
Dallas, TX 75246
Grant Number
H76HA01710
Participating Start Date
4/1/2021
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
7510 FM 1765 STE P1
TEXAS CITY, TX 77591
Pharmacy Comments
Contract Details
Approval Date
7/7/2021
Contract Begin Date
8/27/2021
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
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
7/7/2021
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