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DSH050454RD UCSF-MEDICAL CENTER (ToBeTerminated)
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Main Details
Name
UCSF-MEDICAL CENTER
Subdivision Name
PSYCHO ONCOLOGY PARN - PSYCHO ONCOLOGY PARN
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH050454RD
Medicare Provider Number
050454
Outpatient Facility Provider Number
Additional Details
Current Program Status
ToBeTerminated
Registration Date
1/13/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/20/2023
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
400 PARNASSUS AVE FL 4
San Francisco, CA 94143
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: (10/01/2019) until terminated effective date: (10/01/2020), reinstatement effective date: (04/1/2023)
01/19/2023
April 2025
April 2025
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