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DSH330046E MOUNT SINAI WEST (Terminated)
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Main Details
Name
MOUNT SINAI WEST
Subdivision Name
Center for Comprehensive Care West 17th Street Division
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330046E
Medicare Provider Number
330046
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/13/2013
Last Recertification Date
9/4/2020
Termination Date
Termination Reason
1/1/2021
Site closure
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
230 west 17th street
New York City, NY 10011
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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