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PRISM HEALTH NORTH TEXAS PHARMACY #2
FQHCLA471 AIDS ARMS INC
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Covered Entity Details
Entity Name
AIDS ARMS INC
Subdivision Name
Prism Health North Texas at Worth Street Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA471
Entity Address
4004 Worth Street STE 100
Dallas, TX 75246-1638
Grant Number
LALCS53449
Participating Start Date
10/1/2024
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
PRISM HEALTH NORTH TEXAS PHARMACY #2
Pharmacy Address
219 SUNSET AVE STE 116A, CONFERENCE 1A
DALLAS, TX 75208-4531
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
Equitas Health
Thomas Nicholas Saltsman, Chief Pharmacy Officer
(614) 987-5621
Signed By Date
4/23/2025
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