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DSH050228C Zuckerberg San Francisco General (Terminated)
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Main Details
Name
Zuckerberg San Francisco General
Subdivision Name
ZSFG / Urgent Care Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050228C
Medicare Provider Number
050228
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/20/2015
Last Recertification Date
9/7/2018
Termination Date
Termination Reason
10/1/2019
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
ZSFG
Susan Ehrlich, CEO
(628) 206-8118
Primary Contact
ZSFG
David Woods, Chief Pharmacy Officer
(628) 206-2332
Addresses
Street Address
995 Potrero Avenue, Ward 81
San Francisco, CA 94110
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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