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AIDS HEALTHCARE FOUNDATION
RWI33301 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
AHF Healthcare Center - One River Plaza
Type
Ryan White Part A
340B ID
RWI33301
Entity Address
700 SE 3rd Avenue
Suite 301
Fort Lauderdale, FL 33316
Grant Number
H89HA00002
Participating Start Date
4/1/2014
Last Recertification Date
2/20/2025
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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