340B Drug Pricing Program Database
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DSH050454PD UCSF-MEDICAL CENTER (ToBeTerminated)
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Main Details
Name
UCSF-MEDICAL CENTER
Subdivision Name
Surgery-Vascular
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050454PD
Medicare Provider Number
050454
Outpatient Facility Provider Number
Additional Details
Current Program Status
ToBeTerminated
Registration Date
1/6/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/2/2017
Last Recertification Date
8/13/2024
Termination Date
Termination Reason
7/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
UCSF
Angelie Gaweco, CFO
(415) 928-9900
Primary Contact
UCSF Medical Center
Raechel Hahn, 340B Analyst
(510) 736-7335
Addresses
Street Address
535 Mission Bay Blvd South
San Francisco, CA 94158-2156
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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