Covered Entity Details

DSH100034 MOUNT SINAI MEDICAL CENTER (Active)

Main Details

Name

MOUNT SINAI MEDICAL CENTER

Subdivision Name

MOUNT SINAI MEDICAL CENTER OF FLORIDA INC.

Type

Disproportionate Share Hospital

Rural

340B ID

DSH100034

Medicare Provider Number

100034

Additional Details

Current Program Status

Active

Registration Date

1/18/2007

Participating Start Date

4/1/2007

Participating Approval Date

1/18/2007

Last Recertification Date

9/3/2024

Contacts

Authorizing Official

Mount Sinai Medical Center
ANGEL PALLIN, SVP OF OPERATIONS
(305) 674-2520

Primary Contact

Mount Sinai Medical Center
ANA CAROLINA CALDERA, DIRECTOR OF PHARMACY
(305) 674-2855

Addresses

Street Address

4300 Alton Road
MIAMI BEACH, FL 33140

Billing Address
Same as Street Address

Comment	Last Updated On
1 Item 1 to 4 of 4 Page: of 1 Page size:

1 Item 1 to 4 of 4 Page: of 1 Page size:
7/25/11 ADDED SHIP-TO ADD AND NPI#; 7/19/2011- DOC. RECD TO CONFIRM NON-PROFIT STATUS 3/24/2010- DOC. RECD. TO CONFIRM ELIG. OWNERSHIP TYPE	07/25/2011
7/25/11 ADDED SUBDIV NAME, UPDATED PHYS ADD (WAS 4300 ALTON ROAD); 7/19/2011- DOC. RECD TO CONFIRM NON-PROFIT STATUS 3/24/2010- DOC. RECD. TO CONFIRM ELIG. OWNERSHIP TYPE	07/25/2011
7/19/2011- DOC. RECD TO CONFIRM NON-PROFIT STATUS 3/24/2010- DOC. RECD. TO CONFIRM ELIG. OWNERSHIP TYPE	07/20/2011
3/24/2010- DOC. RECD. TO CONFIRM ELIG. OWNERSHIP TYPE	01/18/2007

340B Drug Pricing Program Database