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DSH050454BS UCSF-MEDICAL CENTER (Terminated)
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Main Details
Name
UCSF-MEDICAL CENTER
Subdivision Name
Facial Plastics- CC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050454BS
Medicare Provider Number
050454
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/20/2023
Last Recertification Date
8/23/2023
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
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
2330 Post St 5th floor
San Francisco, CA 94115
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: (07/01/2012) until terminated effective date: (07/01/2021), reinstatement effective date: (04/1/2023)
01/19/2023
April 2025
April 2025
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