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DIPLOMAT SPECIALTY INFUSION GROUP
HM4799 HEMOPHILIA OF GEORGIA, INC.
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Covered Entity Details
Entity Name
HEMOPHILIA OF GEORGIA, INC.
Subdivision Name
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM4799
Entity Address
8607 Roberts Drive
Suite 150
Sandy Springs, GA 30350
Grant Number
H30MC24046
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
DIPLOMAT SPECIALTY INFUSION GROUP
Pharmacy Address
10607 & 10611 AURORA AVE
URBANDALE, IA 50322-7927
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/4/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Edith A Rosato, CEO
(770) 518-8272
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/15/2021
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