Contract Pharmacy Details

WALGREEN CO.
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

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04013
18207 MIDWAY ROAD
DALLAS, TX 75287

Pharmacy Comments

Contract Details

Approval Date

9/22/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

John T. Carlo, CEO
(214) 521-5191

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

9/22/2021

340B Drug Pricing Program Database