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DSH100034A MOUNT SINAI MEDICAL CENTER (Active)
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Main Details
Name
MOUNT SINAI MEDICAL CENTER
Subdivision Name
COMPREHENSIVE CANCER CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100034A
Medicare Provider Number
100034
Outpatient Facility Provider Number
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
4306 ALTON ROAD
MIAMI BEACH, FL 33140
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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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
April 2025
April 2025
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