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DIPLOMAT SPECIALTY PHARMACY
CH032700 KEYSTONE RURAL HEALTH CENTER
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Covered Entity Details
Entity Name
KEYSTONE RURAL HEALTH CENTER
Subdivision Name
ADMINISTRATION
Type
HRSA-Funded Health Center
340B ID
CH032700
Entity Address
111 Chambers Hill Drive, Suite 200
CHAMBERSBURG, PA 17201
Grant Number
H80CS00076
Participating Start Date
1/1/2000
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
DIPLOMAT SPECIALTY PHARMACY
Pharmacy Address
4100 S SAGINAW ST
STE D
FLINT, MI 48507-2683
Pharmacy Comments
04/09/2012 update address and name (added suite)
Contract Details
Approval Date
1/4/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JOANNE COCHRAN, PRESIDENT AND CEO
(717) 709-7906
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/4/2021
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