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DIAMOND PHARMACY SERVICE
STD59722 Montana Department of Public Health and Human Services/MSP
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Covered Entity Details
Entity Name
Montana Department of Public Health and Human Services/MSP
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD59722
Entity Address
400 Conley Lake Road
Deer Lodge, MT 59722
Grant Number
NH25PS005168-05-00
Participating Start Date
1/1/2023
Last Recertification Date
5/13/2024
Pharmacy Details
Pharmacy Name
DIAMOND PHARMACY SERVICE
Pharmacy Address
DIAMOND PHARMACY SERVICES
645 KOLTER DRIVE
INDIANA, PA 15701
Pharmacy Comments
Contract Details
Approval Date
4/4/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cindy McGillis-Hiner, Health Services Bureau Chief
(406) 444-5439
Contract Pharmacy Representative
Diamond Pharmacy Services
Mark Zilmer, Chief Operating Officer
(800) 882-6337 Ext: 1036
Signed By Date
4/4/2023
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