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AIDS HEALTHCARE FOUNDATION DBA CASTRO PH
RWI946091 Primary Care at Home, INC.
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Covered Entity Details
Entity Name
Primary Care at Home, INC.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI946091
Entity Address
400 - 29th Street
Suite 306
Oakland, CA 94609
Grant Number
H89HA00018
Participating Start Date
5/10/2021
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
AIDS HEALTHCARE FOUNDATION DBA CASTRO PH
Pharmacy Address
518-A CASTRO ST
SAN FRANCISCO, CA 94114
Pharmacy Comments
Contract Details
Approval Date
5/5/2021
Contract Begin Date
5/13/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Anthony E. Jones, Board Chair
(510) 822-2588
Contract Pharmacy Representative
AIDS HEALTHCARE FOUNDATION
Peter Reis, Senior Vice President
(323) 860-5208
Signed By Date
4/6/2021
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