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PHARMACY4HUMANITY
STD787051 AIDS Healthcare Foundation
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Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF Austin Wellness Center
Type
Sexually Transmitted Diseases
340B ID
STD787051
Entity Address
2927 Guadalupe Street
Austin, TX 78705
Grant Number
NU62PS924644
Participating Start Date
10/1/2024
Last Recertification Date
5/28/2025
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
8/27/2024
Contract Begin Date
10/1/2024
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
7/11/2024
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