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DIAMOND PHARMACY SERVICE
STD40031 Kentucky Cabinet for Health and Family Services
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Covered Entity Details
Entity Name
Kentucky Cabinet for Health and Family Services
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD40031
Entity Address
1612 Dawkins Road
LaGrange, KY 40031
Grant Number
NU51PS005175
Participating Start Date
1/1/2024
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
DIAMOND PHARMACY SERVICE
Pharmacy Address
DIAMOND PHARMACY SERVICES
645 KOLTER DRIVE
INDIANA, PA 15701
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cookie Crews, Commissioner
(502) 225-6513
Contract Pharmacy Representative
Diamond Pharmacy
Matt Risko, Director Eastern Division
(800) 882-6337 Ext: 1050
Signed By Date
4/15/2024
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