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AHF PHARMACY
RWI89030 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
AHF North Las Vegas Healthcare Center
Type
Ryan White Part A
340B ID
RWI89030
Entity Address
1815 E.Lake Mead Blvd. Suite 113
North Las Vegas, NV 89030
Grant Number
H89HA06900
Participating Start Date
7/1/2014
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
AHF PHARMACY
Pharmacy Address
AIDS HEALTHCARE FOUNDATION
1988 HACIENDA DR
VISTA, CA 92081-6026
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
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
10/13/2023
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