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AHF PHARMACY
RWII78208 San Antonio AIDS Foundation
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Covered Entity Details
Entity Name
San Antonio AIDS Foundation
Subdivision Name
Type
Ryan White Part B
340B ID
RWII78208
Entity Address
818 East Grayson Street
San Antonio, TX 78208-1013
Grant Number
X07HA00054
Participating Start Date
7/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
AHF PHARMACY
Pharmacy Address
AIDS HEALTHCARE FOUNDATION
400 N BEACH ST STE 102
FORT WORTH, TX 76111
Pharmacy Comments
Contract Details
Approval Date
4/15/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/6/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
David T. Ewell, Executive Director
(210) 225-4715 Ext: 122
Contract Pharmacy Representative
aidshealth
SCOTT CARRUTHERS, SR. MANAGER, CHIEF PHARMACY OFFICER
(323) 860-5200 Ext: 5266
Signed By Date
4/15/2013
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