Provider Demographics
NPI:1750586764
Name:AIDS HEALTHCARE FOUNDATION
Entity type:Organization
Organization Name:AIDS HEALTHCARE FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:STIDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-522-3132
Mailing Address - Street 1:110 SE 6TH ST
Mailing Address - Street 2:SUITE 1960
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-5000
Mailing Address - Country:US
Mailing Address - Phone:954-522-3132
Mailing Address - Fax:954-522-3260
Practice Address - Street 1:110 SE 6TH ST
Practice Address - Street 2:SUITE 1960
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-5000
Practice Address - Country:US
Practice Address - Phone:954-522-3132
Practice Address - Fax:954-522-3260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization