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AHF PHARMACY
STD752192 AIDS Healthcare Foundation
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Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF PHD Dallas OTC Wellness
Type
Sexually Transmitted Diseases
340B ID
STD752192
Entity Address
3920 Cedar Springs Rd.
Dallas, TX 75219
Grant Number
NH25PS005182
Participating Start Date
7/1/2022
Last Recertification Date
5/28/2024
Pharmacy Details
Pharmacy Name
AHF PHARMACY
Pharmacy Address
AIDS HEALTHCARE FOUNDATION
3920 CEDAR SPRINGS RD
DALLAS, TX 75219-3518
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
2/23/2024
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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