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DSH330046C ST LUKE'S ROOSEVELT HOSPITAL CENTER (Terminated)
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Main Details
Name
ST LUKE'S ROOSEVELT HOSPITAL CENTER
Subdivision Name
TRANSPLANT PROGRAM
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330046C
Medicare Provider Number
330046
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
5/29/2009
Participating Start Date
7/1/2009
Participating Approval Date
6/8/2009
Last Recertification Date
9/9/2014
Termination Date
Termination Reason
7/1/2015
Site closure
Contacts
Authorizing Official
Mount Sinai
Michael Pastier, Senior VP/CFO - The Mount Sinai Hospital
(212) 731-3149
Primary Contact
KAREN VITACOLONNA FALK, DIRECTOR OF PHARMACY
(212) 523-2584
Addresses
Street Address
2074 Frederick Douglas Boulevard
NEW YORK, NY 10026
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/27/12 UPDATED MAIN ADD (WAS 1090 AMSTERDAM AVENUE, 12TH FLOOR, NEW YORK, NY 10025)
03/27/2012
June 2025
June 2025
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