Contract Pharmacy Details

DIPLOMAT SPECIALTY PHARMACY
CH090710 COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.

Covered Entity Details

Entity Name

COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.

Subdivision Name

NIPOMO COMMUNITY MEDICAL CENTER

Type

HRSA-Funded Health Center

340B ID

CH090710

Entity Address

150 TEJAS PL
NIPOMO, CA 93444-9123

Grant Number

H80CS00621

Participating Start Date

4/1/1996

Last Recertification Date

2/11/2025

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

8/17/2012

Contract Begin Date

8/17/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/4/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

RONALD E. CASTLE, CEO
(805) 459-1835

Contract Pharmacy Representative

Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677

Signed By Date

8/6/2012

340B Drug Pricing Program Database