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AIDS HEALTHCARE FOUNDATION
RWI11432 AIDS Center of Queens County, Inc.
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Covered Entity Details
Entity Name
AIDS Center of Queens County, Inc.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI11432
Entity Address
161-21 Jamaica Avenue, 6th Floor
Jamaica, NY 11432-6113
Grant Number
H89HA00015
Participating Start Date
10/1/2013
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
AIDS HEALTHCARE FOUNDATION
Pharmacy Address
AHF PHARMACY
4630 BORDER VILLAGE RD STE K
SAN YSIDRO, CA 92173
Pharmacy Comments
Contract Details
Approval Date
10/4/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/4/2024
Agreement registered in error
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
10/4/2024
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