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DIAMOND PHARMACY SERVICE
STD17866 Pennsylvania Department of Corrections
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Covered Entity Details
Entity Name
Pennsylvania Department of Corrections
Subdivision Name
State Correctional Institution Coal Township
Type
Sexually Transmitted Diseases
340B ID
STD17866
Entity Address
1 Kelley Drive
Coal Township, PA 17866
Grant Number
NU62PS924544
Participating Start Date
4/1/2023
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
DIAMOND PHARMACY SERVICE
Pharmacy Address
DIAMOND PHARMACY SERVICES
645 KOLTER DRIVE
INDIANA, PA 15701
Pharmacy Comments
Contract Details
Approval Date
4/11/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Erica Benning, Director of Healthcare
(717) 728-5311
Contract Pharmacy Representative
Diamond Pharmacy Services
Gustave A. Gabrielson, Account Executive
(724) 349-1111 Ext: 1018
Signed By Date
4/11/2023
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