Contract Pharmacy Details

EXPRESS SCRIPTS PHARMACY, INC.
HV01710B 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

Uptown Clinic

Type

Ryan White Part C

340B ID

HV01710B

Entity Address

2801 Lemmon Ave
Suite 400
Dallas, TX 75204

Grant Number

H76HA01710

Participating Start Date

4/1/2019

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

EXPRESS SCRIPTS PHARMACY, INC.

Pharmacy Address

DBA EXPRESS SCRIPTS
4750 E. 450 S.
WHITESTOWN, IN 46075

Pharmacy Comments

Contract Details

Approval Date

10/18/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

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

Contract Pharmacy Representative

Express Scripts
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500

Signed By Date

10/18/2021

340B Drug Pricing Program Database