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AHF PHARMACY WEST HOLLYWOOD
RWI94609 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
AHF HEALTHCARE CENTER - OAKLAND
Type
Ryan White Part A
340B ID
RWI94609
Entity Address
400 30TH STREET, SUITE 300
OAKLAND, CA 94609
Grant Number
H89HA00018
Participating Start Date
4/1/2009
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
AHF PHARMACY WEST HOLLYWOOD
Pharmacy Address
AIDS HEALTHCARE FOUNDATION
8212 SANTA MONICA BVLD.
WEST HOLLYWOOD, CA 90046
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/9/2024
Ownership change
Contacts
Covered Entity Signing Official
Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022
Contract Pharmacy Representative
AIDS HEALTHCARE FOUNDATION
Scott Carruthers, Chief Pharmacy Officer
(323) 860-5200 Ext: 5266
Signed By Date
10/12/2023
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