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DSH050599BZ UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER (Active)
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Main Details
Name
UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER
Subdivision Name
PLACER CENTER FOR HEALTH / ROCKLIN INFUSION
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050599BZ
Medicare Provider Number
050599
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/30/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/5/2014
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
UC Davis Health
Jennifer L Doll, Chief Financial Officer
(916) 708-2708
Primary Contact
UC Davis Medical Center
Mark Riggle, Assistant Chief Pharmacist
(916) 734-3309
Addresses
Street Address
550 WEST RANCH VIEW DR
Suite 1500
ROCKLIN, CA 95765
Billing Address
UNIVERSITY OF CALIFORNIA - DAVIS MEDICAL CENTER
PO Box 168016
SACRAMENTO, CA 95816
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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