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WINN-DIXIE #525
CH044120 QUALITY OF LIFE HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
QUALITY OF LIFE HEALTH SERVICES, INC.
Subdivision Name
QUALITY OF LIFE HEALTH COMPLEX
Type
HRSA-Funded Health Center
340B ID
CH044120
Entity Address
1411 PIEDMONT CUTOFF
GADSDEN, AL 35903-2708
Grant Number
H80CS00658
Participating Start Date
12/1/1992
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
WINN-DIXIE #525
Pharmacy Address
815 SOUTH PELHAM RD
JACKSONVILLE, AL 36265
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/18/2022
Agreement registered in error
Contacts
Covered Entity Signing Official
WAYNE ROWE, CEO
(256) 492-0131
Contract Pharmacy Representative
Southeastern Grociers
David Chism, Seinior Director
(904) 370-6455 Ext: 9043706455
Signed By Date
10/16/2017
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