340B Drug Pricing Program Database
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DSH050454HW UCSF-MEDICAL CENTER (Terminated)
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Main Details
Name
UCSF-MEDICAL CENTER
Subdivision Name
PSYCHOLOGY ONC MZ CC4
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050454HW
Medicare Provider Number
050454
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/8/2016
Last Recertification Date
8/19/2016
Termination Date
Termination Reason
1/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
UCSF Health
James Bennan, COO Community Hospital Division
(415) 503-8667
Primary Contact
UCSF Medical Center
Amy Hunt, 340B Manager
(415) 514-8398
Addresses
Street Address
1600 DIVISADERO 4TH FL
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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