340B Drug Pricing Program Database
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DSH050454RC UCSF-MEDICAL CENTER (Terminated)
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Main Details
Name
UCSF-MEDICAL CENTER
Subdivision Name
Investigational Therapy MB - Investigational Therapy MB
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050454RC
Medicare Provider Number
050454
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/5/2021
Participating Start Date
7/1/2021
Participating Approval Date
4/7/2021
Last Recertification Date
Termination Date
Termination Reason
7/1/2021
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
1825 4th Street
3-6 Floors
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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Participating from effective date: (07/01/2019) until terminated effective date: (10/1/2020), reinstatement effective date: (07/01/2021)
04/06/2021
April 2025
April 2025
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