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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
5/21/2024
Pharmacy Details
Pharmacy Name
PHARMACY4HUMANITY
Pharmacy Address
AHF PHARMACY
901 BOREN AVE., STE. 800
SEATTLE, WA 98104
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
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
10/15/2024
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