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DSH050454BK UCSF-MEDICAL CENTER (Active)
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Main Details
Name
UCSF-MEDICAL CENTER
Subdivision Name
Endocrine Practice MZ
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050454BK
Medicare Provider Number
050454
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/13/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/20/2023
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
UCSF
Angelie Gaweco, CFO
(415) 928-9900
Primary Contact
UCSF Medical Center
Raechel Hahn, 340B Analyst
(510) 736-7335
Addresses
Street Address
1600 Divisadero St., 5th Fl
San Francisco, CA 94143
Billing Address
UCSF-MEDICAL CENTER
505 PARNASSUS AVE. ROOM M39C
San Francisco, CA 94143
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (07/1/2012) until terminated effective date: (10/01/2022), reinstatement effective date: (04/1/2023)
01/19/2023
April 2025
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