340B Drug Pricing Program Database
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DSH050454PP UCSF-MEDICAL CENTER (Terminated)
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Main Details
Name
UCSF-MEDICAL CENTER
Subdivision Name
OBGYN - Women's Health
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050454PP
Medicare Provider Number
050454
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/3/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/25/2017
Last Recertification Date
8/20/2019
Termination Date
Termination Reason
10/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
UCSF Health
James Bennan, COO Community Hospital Division
(415) 503-8667
Primary Contact
UCSF Health
Kayla Hubbard, 340B Program Coordinator
(808) 339-5697
Addresses
Street Address
1975 4th Street, 3rd Fl
San Francisco, CA 94158
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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