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FREEMAN PHARMACY
CH04412U QUALITY OF LIFE HEALTH SERVICES INC
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Covered Entity Details
Entity Name
QUALITY OF LIFE HEALTH SERVICES INC
Subdivision Name
Tuskegee Quality Health Care
Type
HRSA-Funded Health Center
340B ID
CH04412U
Entity Address
1201 B Notasulga Road
Tuskegee, AL 36083-2138
Grant Number
H80CS00658
Participating Start Date
1/1/2014
Last Recertification Date
2/6/2020
Entity Termination Date
4/1/2020
Pharmacy Details
Pharmacy Name
FREEMAN PHARMACY
Pharmacy Address
209 W MLK HWY
SUITE D
TUSKEGEE, AL 36083
Pharmacy Comments
Contract Details
Approval Date
1/24/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/4/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
WAYNE ROWE, CEO
(256) 492-0131
Contract Pharmacy Representative
MARK FREEMAN, Pharmacist
(334) 727-0047
Signed By Date
1/24/2014
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