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OPTUM PHARMACY 701, LLC
STD752041 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 Lawn Health Center
Type
Sexually Transmitted Diseases
340B ID
STD752041
Entity Address
2801 Lemmon Ave
Suite 200
Dallas, TX 75204
Grant Number
NH25PS005182
Participating Start Date
10/1/2019
Last Recertification Date
5/29/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 701, LLC
Pharmacy Address
4100 S SAGINAW ST STE D
FLINT, MI 48507
Pharmacy Comments
Contract Details
Approval Date
4/23/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John T. Carlo, CEO
(214) 521-5191
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
4/23/2025
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