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DIPLOMAT SPECIALTY PHARMACY
DSH340070 ALAMANCE REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
ALAMANCE REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340070
Entity Address
1240 HUFFMAN MILL ROAD
BURLINGTON, NC 27215
Medicare Provider Number
340070
Participating Start Date
7/1/2015
Last Recertification Date
8/29/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
DIPLOMAT SPECIALTY PHARMACY
Pharmacy Address
7 CREEK PKWY STE 700
UPPER CHICHESTER, PA 19061-3100
Pharmacy Comments
Contract Details
Approval Date
1/17/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/8/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jeffrey Jones, Executive VP and CFO
(336) 832-8005
Contract Pharmacy Representative
Diplomat Specialty
Robert Shaw, Pharmacy Manager
(610) 876-6068
Signed By Date
1/17/2019
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