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MEDEXPRESS PHARMACY, LTD.
HV28474 Quality Home Care Services
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Covered Entity Details
Entity Name
Quality Home Care Services
Subdivision Name
Type
Ryan White Part C
340B ID
HV28474
Entity Address
3627 Beatties Ford Road
Charlotte, NC 28216
Grant Number
H76HA28474
Participating Start Date
1/1/2018
Last Recertification Date
2/21/2022
Entity Termination Date
1/1/2023
Pharmacy Details
Pharmacy Name
MEDEXPRESS PHARMACY, LTD.
Pharmacy Address
1431 W. INNES ST.
SALISBURY, NC 28144
Pharmacy Comments
Contract Details
Approval Date
1/10/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lisa Wigfall, CEO
(980) 721-1573
Contract Pharmacy Representative
AVITA Pharmacy
JERRY PURCEL, Executive VP
(504) 905-4587
Signed By Date
1/10/2018
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