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WAL-MART PHARMACY 10-1284
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
WAL-MART PHARMACY 10-1284
Pharmacy Address
3700 HWY 280/431 NORTH
PHENIX CITY, AL 36867
Pharmacy Comments
Contract Details
Approval Date
10/21/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
WAYNE ROWE, CEO
(256) 492-0131
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
10/21/2016
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