Contract Pharmacy Details

DIPLOMAT SPECIALTY PHARMACY
DSH230207 McLaren Oakland

Covered Entity Details

Entity Name

McLaren Oakland

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH230207

Entity Address

50 NORTH PERRY
PONTIAC, MI 48342

Medicare Provider Number

230207

Participating Start Date

1/1/2005

Last Recertification Date

8/26/2024

Pharmacy Details

Pharmacy Name

DIPLOMAT SPECIALTY PHARMACY

Pharmacy Address

G3320 BEECHER RD
FLINT, MI 48532-3614

Pharmacy Comments

Contract Details

Approval Date

1/14/2014

Contract Begin Date

4/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/31/2019
Pharmacy closed

Contacts

Covered Entity Signing Official

FRED KORTE, CFO
(248) 338-5691

Contract Pharmacy Representative

Teri Johnson, Manager
(810) 732-2580

Signed By Date

1/14/2014