Contract Pharmacy Details

RANDALLS FOOD AND DRUGS LP
HV01710D 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

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

RANDALLS FOOD AND DRUGS LP

Pharmacy Address

TOM THUMB PHARMACY #3563
633 WHEATLAND RD
DUNCANVILLE, TX 75116

Pharmacy Comments

Contract Details

Approval Date

7/26/2021

Contract Begin Date

8/27/2021

Carve-In Effective Date

Contract Comments

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

7/26/2021

340B Drug Pricing Program Database