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PHARMACY4HUMANITY
STD90027 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
HOLLYWOOD WELLNESS CENTER
Type
Sexually Transmitted Diseases
340B ID
STD90027
Entity Address
1811 N. Western Ave.
Los Angeles, CA 90027
Grant Number
NH25PS004325
Participating Start Date
7/1/2015
Last Recertification Date
5/20/2025
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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