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CRESCENT HEALTHCARE, INC.
HM95817 UNIVERSITY OF CALIFORNIA, DAVIS
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Covered Entity Details
Entity Name
UNIVERSITY OF CALIFORNIA, DAVIS
Subdivision Name
CANCER CENTER PEDIATRIC HEMATOLOGY - HTC
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM95817
Entity Address
2279 45TH ST
SACRAMENTO, CA 95817
Grant Number
H30MC24045
Participating Start Date
4/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
CRESCENT HEALTHCARE, INC.
Pharmacy Address
25901 INDUSTRIAL BLVD BLDG E
HAYWARD, CA 94545-2995
Pharmacy Comments
Contract Details
Approval Date
7/13/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
TIMOTHY MAURICE, CHIEF FINANCIAL OFFICER
(916) 734-4055
Contract Pharmacy Representative
Option Care
Derek Bilyk, Program Manager, Health Systems
(224) 813-1283
Signed By Date
7/13/2021
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