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DIPLOMAT SPECIALTY PHARMACY
DSH060054 COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH060054
Entity Address
2351 G ROAD
GRAND JUNCTION, CO 81505
Medicare Provider Number
060054
Participating Start Date
4/1/2021
Last Recertification Date
8/23/2024
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
4/7/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christian A. Thomas, CEO
(970) 644-3011
Contract Pharmacy Representative
Optum
Avani Patel, VP, 340B Operations
(763) 330-5555
Signed By Date
4/7/2025
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