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PHARMACY4HUMANITY
STD76111 AIDS Outreach Center, Inc.
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Covered Entity Details
Entity Name
AIDS Outreach Center, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD76111
Entity Address
400 N. Beach Street
100
Fort Worth, TX 76111-7010
Grant Number
NH25PS005182
Participating Start Date
1/1/2021
Last Recertification Date
5/28/2024
Pharmacy Details
Pharmacy Name
PHARMACY4HUMANITY
Pharmacy Address
AHF PHARMACY
901 BOREN AVE., STE. 800
SEATTLE, WA 98104
Pharmacy Comments
Contract Details
Approval Date
4/7/2025
Contract Begin Date
7/1/2025
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
4/7/2025
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