Contract Pharmacy Details

GARFIELD BEACH CVS, L.L.C.
DSH050454 UCSF-MEDICAL CENTER

Covered Entity Details

Entity Name

UCSF-MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH050454

Entity Address

505 PARNASSUS AVE.
SAN FRANCISCO, CA 94143

Medicare Provider Number

050454

Participating Start Date

7/1/1993

Last Recertification Date

8/16/2024

Pharmacy Details

Pharmacy Name

GARFIELD BEACH CVS, L.L.C.

Pharmacy Address

CVS/PHARMACY #11107
701 VAN NESS AVENUE
SAN FRANCISCO, CA 94102

Pharmacy Comments

Contract Details

Approval Date

9/10/2020

Contract Begin Date

9/10/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

James Bennan, COO Community Hospital Division
(415) 503-8667

Contract Pharmacy Representative

Caremark L.L.C.
Christian reid, 340b Program Director
(401) 770-2118

Signed By Date

9/10/2020

340B Drug Pricing Program Database