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KROGER PHARMACY #870
STD75208 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
Oak Cliff Clinic
Type
Sexually Transmitted Diseases
340B ID
STD75208
Entity Address
219 Sunset Ave
Suite 116-A
Dallas, TX 75208
Grant Number
NH25PS005182
Participating Start Date
4/1/2015
Last Recertification Date
5/14/2024
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #870
Pharmacy Address
3770 BELT LINE ROAD
ADDISON, TX 75001
Pharmacy Comments
Contract Details
Approval Date
7/25/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John T. Carlo, CEO
(214) 521-5191
Contract Pharmacy Representative
Kroger Health
Eva Brumfield, Strategic Program Director
(651) 357-2109
Signed By Date
7/25/2023
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