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HM92025 Rady Children's Hospital -- San Diego (Active)
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Main Details
Name
Rady Children's Hospital -- San Diego
Subdivision Name
Hemophilia Treatment Center
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM92025
Grant Number
H30MC24045
Additional Details
Current Program Status
Active
Registration Date
7/6/2016
Participating Start Date
10/1/2016
Participating Approval Date
7/29/2016
Last Recertification Date
2/19/2025
Contacts
Authorizing Official
Rady Children's Hospital San Diego
Charles Brendan Davis, Interim Chief Operating Officer
(858) 966-4001
Primary Contact
Rady Children's Hospital San Diego
MICHAEL DWAINE CLARK, PHARMACY MANAGER
(858) 966-4941 Ext: 6917
Addresses
Street Address
2125 Citricado Parkway Suite 200
Escondido, CA 92029
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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