340B Drug Pricing Program Database
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DSH050025AP UCSD MEDICAL CENTER (Active)
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Main Details
Name
UCSD MEDICAL CENTER
Subdivision Name
Encinitas Radiation Oncology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050025AP
Medicare Provider Number
050025
Outpatient Facility Provider Number
050025
Additional Details
Current Program Status
Active
Registration Date
7/11/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/8/2014
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
UCSD Medical Center
Lori Donaldson, CFO
(619) 543-6613
Primary Contact
UCSD Medical Center
Katrina Tolentino, 340B Program Coordinator
(619) 543-3104
Addresses
Street Address
1200 Garden View Road
Suite 210
Encinitas, CA 92024
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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