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General NPI Number Information
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NPI Number | 1366950867
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Entity Type | Organization
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Legal Business Name | AIDS HEALTH FOUNDATION
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 3400 26TH AVE S
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City | ST PETERSBURG
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State | FL
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Zip | 33711-3537
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Country | US
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Telephone | 323-436-5019
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Fax |
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Provider Business Mailing Address
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Address Line | 6255 W SUNSET BLVD FL 21
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City | LOS ANGELES
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State | CA
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Zip | 90028-7422
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Country | US
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Telephone | 323-860-5200
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Fax | 833-241-7615
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Authorized Official
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Title or Position | CHIEF OF MANAGED CARE
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Name | DONNA STIDHAM
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Credential |
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Telephone | 323-436-5025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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