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NPI 1174908883

NPI 1174908883 : AIDS HEALTHCARE FOUNDATION : LAS VEGAS, NV

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General NPI Number Information
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    NPI Number           |    1174908883
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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     |    07/23/2015
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    Last Update Date     |    12/03/2025
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Provider Practice Location Address
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    Address Line         |    3201 S MARYLAND PKWY STE 218 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89109-2424
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    Country              |    US
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    Telephone            |    702-826-5310
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    Fax                  |    702-826-5311
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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    |    CHIEF OF PHARMACY
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    Name                 |     KENNETH 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        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    PH03380
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    License Number State |    NV
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Taxonomy #2
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    Taxonomy Code        |    3336S0011X
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    Taxonomy Name        |    Specialty Pharmacy
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    License Number       |    
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    License Number State |    
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