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AHF PHARMACY
RWI94612 AIDS Project of the East Bay
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Covered Entity Details
Entity Name
AIDS Project of the East Bay
Subdivision Name
Type
Ryan White Part A
340B ID
RWI94612
Entity Address
1320 Webster Street
Oakland, CA 94612
Grant Number
H89HA00018
Participating Start Date
10/1/2012
Last Recertification Date
2/20/2018
Entity Termination Date
4/1/2019
Pharmacy Details
Pharmacy Name
AHF PHARMACY
Pharmacy Address
AIDS HEALTHCARE FOUNDATION
400 30TH ST STE 300
OAKLAND, CA 94609
Pharmacy Comments
Contract Details
Approval Date
7/14/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/24/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Alvan Quamina, Executive Director
(510) 435-7688
Contract Pharmacy Representative
Signed By Date
7/14/2014
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