Contract Pharmacy Details

AHF PHARMACY
RWI606161D AIDS Healthcare Foundation

Covered Entity Details

Entity Name

AIDS Healthcare Foundation

Subdivision Name

AHF Chicago - Lakeview

Type

Ryan White Part A

340B ID

RWI606161D

Entity Address

3311 N. Halsted Street
Chicago, IL 60657

Grant Number

H89HA00008

Participating Start Date

1/1/2021

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