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AHF PHARMACY
FQHCLA414A Metro Health Inc
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Covered Entity Details
Entity Name
Metro Health Inc
Subdivision Name
Metro Health Secondary Site
Type
Health Center Program Look-Alike
340B ID
FQHCLA414A
Entity Address
801 Pennsylvania Ave SE Ste 201
Washington, DC 20003-2152
Grant Number
LALCS39530
Participating Start Date
1/1/2021
Last Recertification Date
2/17/2021
Entity Termination Date
4/1/2022
Pharmacy Details
Pharmacy Name
AHF PHARMACY
Pharmacy Address
AIDS HEALTHCARE FOUNDATION
2141 K ST NW STE 707
WASHINGTON, DC 20037-1810
Pharmacy Comments
Contract Details
Approval Date
10/14/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Miguel McInnis, CEO
(202) 838-9271
Contract Pharmacy Representative
AIDS HEALTHCARE FOUNDATION
Scott Carruthers, Chief Pharmacy Officer
(323) 860-5200 Ext: 5266
Signed By Date
10/14/2020
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