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STONE SOUP ENTERPRISES, INC.
HM1598 UCSF Benioff Children's Hospitals Hemophilia Treatment Center
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Covered Entity Details
Entity Name
UCSF Benioff Children's Hospitals Hemophilia Treatment Center
Subdivision Name
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM1598
Entity Address
550 16th St. 4th Fl
MAILSTOP 0434
SAN FRANCISCO, CA 94143
Grant Number
H30MC24045
Participating Start Date
10/1/2000
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
STONE SOUP ENTERPRISES, INC.
Pharmacy Address
18009 SKYPARK CIRCLE, STE G
IRVINE, CA 92614
Pharmacy Comments
Contract Details
Approval Date
12/2/2004
Contract Begin Date
12/2/2004
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/20/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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