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AHF PHARMACY
RWII30309 AID Atlanta Inc
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Covered Entity Details
Entity Name
AID Atlanta Inc
Subdivision Name
Type
Ryan White Part B
340B ID
RWII30309
Entity Address
770 Greison Trail
Suite H
Newnan, GA 30263
Grant Number
X08HA28021
Participating Start Date
7/1/2015
Last Recertification Date
2/28/2025
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
10/16/2023
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
10/16/2023
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