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DIAMOND PHARMACY SERVICE
STD55112 Minnesota Department of Corrections
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Covered Entity Details
Entity Name
Minnesota Department of Corrections
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD55112
Entity Address
1450 Energy Park Drive
Suite 200
St. Paul, MN 55108
Grant Number
5 NH25PS005172-03-00
Participating Start Date
4/1/2019
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
DIAMOND PHARMACY SERVICE
Pharmacy Address
DIAMOND PHARMACY SERVICES
645 KOLTER DRIVE
INDIANA, PA 15701
Pharmacy Comments
Contract Details
Approval Date
10/18/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michelle Smith, Deputy Commissioner
(651) 361-7217
Contract Pharmacy Representative
Diamond Pharmacy Services
Mark Zilmer, Chief Operating Officer
(800) 882-6337 Ext: 1036
Signed By Date
10/18/2019
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