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CRESCENT HEALTHCARE, INC.
DSH050454 UCSF-MEDICAL CENTER
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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
CRESCENT HEALTHCARE, INC.
Pharmacy Address
CRESCENT HEALTHCARE
11980 TELEGRAPH RD STE 102
SANTA FE SPRINGS, CA 90670-6087
Pharmacy Comments
Contract Details
Approval Date
7/9/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Bennan, COO Community Hospital Division
(415) 503-8667
Contract Pharmacy Representative
Option Care
Jenny Money, Senior Manager, Health Systems Programs
(773) 202-6786
Signed By Date
7/9/2021
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