340B Drug Pricing Program Database
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DSH050454BZ UCSF-MEDICAL CENTER (Terminated)
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Main Details
Name
UCSF-MEDICAL CENTER
Subdivision Name
GI / Liver Practice
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050454BZ
Medicare Provider Number
050454
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/4/2021
Participating Start Date
7/1/2021
Participating Approval Date
4/7/2021
Last Recertification Date
9/7/2022
Termination Date
Termination Reason
7/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
UCSF Health
James Bennan, COO Community Hospital Division
(415) 503-8667
Primary Contact
UCSF Health
Kayla Hubbard, 340B Program Coordinator
(808) 339-5697
Addresses
Street Address
350 Parnassus Ave
3rd Floor
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: (7/1/2012), until terminated effective date: (1/1/2018), reinstatement effective date: (07/01/2021)
04/06/2021
April 2025
April 2025
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