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BIOLOGICS, INC.
DSH050262 RONALD REAGAN UCLA MEDICAL CENTER
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Covered Entity Details
Entity Name
RONALD REAGAN UCLA MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050262
Entity Address
757 WESTWOOD PLAZA
LOS ANGELES, CA 90095
Medicare Provider Number
050262
Participating Start Date
1/1/1998
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
BIOLOGICS, INC.
Pharmacy Address
BIOLOGICS BY MCKESSON
11800 WESTON PARKWAY
CARY, NC 27513
Pharmacy Comments
Contract Details
Approval Date
1/10/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tammy Wallace, Chief Financial Officer Hospital System
(310) 794-8627
Contract Pharmacy Representative
Biologics, Inc.
Ela Lourido, Director, Strategic Initiatives
(469) 216-2130
Signed By Date
1/10/2023
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