340B Drug Pricing Program Database
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DSH050262AZ RONALD REAGAN UCLA MEDICAL CENTER (Active)
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Main Details
Name
RONALD REAGAN UCLA MEDICAL CENTER
Subdivision Name
Santa Clarita Radiation Oncology - Radiation Oncology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH050262AZ
Medicare Provider Number
050262
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/9/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/25/2023
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
UCLA Health
Tammy Wallace, Chief Financial Officer Hospital System
(310) 794-8627
Primary Contact
UCLA
Lana Balderrama, 340B Program Supervisor
(310) 267-1278
Addresses
Street Address
27235 Tourney Rd
1400
Santa Clarita, CA 91355
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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