Contract Pharmacy Details

WALGREEN CO.
HV01710A 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

South Dallas Clinic

Type

Ryan White Part C

340B ID

HV01710A

Entity Address

4922 Spring Ave
Dallas, TX 75210-1359

Grant Number

H76HA01710

Participating Start Date

7/1/2016

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05092
3418 MCKINNEY AVE
DALLAS, TX 75204

Pharmacy Comments

Contract Details

Approval Date

4/14/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

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

Signed By Date

340B Drug Pricing Program Database