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NPI Code Detail

MEDICARE: AIDS HEALTHCARE FOUNDATION

MEDICARE: AIDS HEALTHCARE FOUNDATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/Center

General Provider Information

NPI Number : 1356729164
Entity Type Code : Organization
Provider Name (Legal Business Name) : AIDS HEALTHCARE FOUNDATION
Provider Business Mailing Address
First Line : 6255 W SUNSET BLVD FL 21
Second Line :
City : LOS ANGELES
State : CA
Zip : 90028-7422
Country : US
Telephone Number : 323-860-5200
Fax Number : 833-241-7615
Provider Business Practice Location Address
First Line : 735 PIEDMONT AVE NE
Second Line :
City : ATLANTA
State : GA
Zip : 30308-1416
Country : US
Telephone Number : 404-588-4680
Fax Number : 404-588-4692
Authorized Official
Title or Position : CHIEF, MANAGED CARE
Name : DONNA STIDHAM
Credential :
Telephone Number : 323-436-5025
Provider Enumeration Date : 05/13/2015
Last Update Date : 09/11/2019

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Directions to “AIDS HEALTHCARE FOUNDATION ” Practice Location

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