340B Drug Pricing Program Database
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DSH330169A MOUNT SINAI BETH ISRAEL (Active)
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Main Details
Name
MOUNT SINAI BETH ISRAEL
Subdivision Name
PETRIE DIVISION
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330169A
Medicare Provider Number
330169
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/1/2005
Participating Start Date
7/1/2005
Participating Approval Date
6/2/2005
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Mount Sinai
Michael Pastier, Senior VP/CFO - The Mount Sinai Hospital
(212) 731-3149
Primary Contact
Mount Sinai Health System
Samuel Wilhelm-Ross, 340B Program Director
(646) 605-2006
Addresses
Street Address
330 EAST 17TH STREET
NEW YORK, NY 10003
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/29/10 SUB-DIV NAME CORRECTED (WAS BETH IRAEL MEDICAL CENTER) NEW ADD 7/05
06/29/2010
April 2025
April 2025
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