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General NPI Number Information
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NPI Number | 1164886727
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Entity Type | Organization
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Legal Business Name | AIDS HEALTHCARE FOUNDATION
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Dates
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Enumeration Date | 04/11/2016
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 770 GREISON TRL STE H
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City | NEWNAN
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State | GA
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Zip | 30263-6401
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Country | US
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Telephone | 678-423-5250
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Fax | 678-423-5251
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Provider Business Mailing Address
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Address Line | 18421 S MAIN ST
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City | GARDENA
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State | CA
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Zip | 90248-4609
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Country | US
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Telephone | 310-999-6089
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Fax | 833-261-3712
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Authorized Official
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Title or Position | SR. MANAGER / CHIEF PHARMACY OFFICE
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Name | SCOTT CARRUTHERS
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Credential |
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Telephone | 323-860-5266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE010280
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License Number State | GA
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