Contract Pharmacy Details

AHF PHARMACY
RWI606161C AIDS Healthcare Foundation

Covered Entity Details

Entity Name

AIDS Healthcare Foundation

Subdivision Name

AHF Healthcare Center - Chicago (Hyde Park)

Type

Ryan White Part A

340B ID

RWI606161C

Entity Address

1515 East 52nd Place
Chicago, IL 60615-4390

Grant Number

H89HA00008

Participating Start Date

10/1/2018

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

AHF PHARMACY

Pharmacy Address

1230 N HIGH ST
COLUMBUS, OH 43201-2466

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

3/31/2024
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

340B Drug Pricing Program Database