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PHARMACY4HUMANITY
RWI900152G AIDS Healthcare Foundation
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Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF Healthcare Center - Puerto RIco
Type
Ryan White Part A
340B ID
RWI900152G
Entity Address
Paseo del Prado Shopping Center
PR-3 km 8.4
Suite 107/108
Carolina, PR 00987
Grant Number
H89HA00009
Participating Start Date
7/1/2019
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
PHARMACY4HUMANITY
Pharmacy Address
AHF PHARMACY
19300 S HAMILTON AVE STE 170-180
GARDENA, CA 90248
Pharmacy Comments
Contract Details
Approval Date
6/7/2024
Contract Begin Date
6/10/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2024
Pharmacy closed
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
6/7/2024
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