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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
13336C0003XCommunity/Retail PharmacyPHRE010312GA
2333600000XPharmacy
33336S0011XSpecialty Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12164397OTHERPK

General Provider Information

NPI Number : 1366991283
Entity Type Code : Organization
Provider Name (Legal Business Name) : AIDS HEALTHCARE FOUNDATION
Provider Business Mailing Address
First Line : 18421 S MAIN ST
Second Line :
City : GARDENA
State : CA
Zip : 90248-4609
Country : US
Telephone Number : 310-999-6089
Fax Number : 833-261-3712
Provider Business Practice Location Address
First Line : 659 AUBURN AVE NE STE 156
Second Line :
City : ATLANTA
State : GA
Zip : 30312-1976
Country : US
Telephone Number : 470-447-6471
Fax Number : 470-447-6472
Authorized Official
Title or Position : CHIEF OF PHARMACY
Name : KENNETH SCOTT CARRUTHERS
Credential :
Telephone Number : 323-860-5266
Provider Enumeration Date : 10/04/2016
Last Update Date : 12/03/2025

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Directions to “AIDS HEALTHCARE FOUNDATION ” Practice Location

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