340B Drug Pricing Program Database
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DSH050262AP RONALD REAGAN UCLA MEDICAL CENTER (Active)
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Main Details
Name
RONALD REAGAN UCLA MEDICAL CENTER
Subdivision Name
Radiology MRI- Outpatient
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050262AP
Medicare Provider Number
050262
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
5/12/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/26/2012
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
UCLA Health
Tammy Wallace, Chief Financial Officer Hospital System
(310) 794-8627
Primary Contact
UCLA
Lana Balderrama, 340B Program Supervisor
(310) 267-1278
Addresses
Street Address
100 Medical Plaza, Suite 100
Los Angeles, CA 90095
Billing Address
Ronald Reagan UCLA Medical Center
100 Medical Plaza
Suite 100
Los Angeles, CA 90095
Comments
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Contract Pharmacies
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