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DSH330024T THE MOUNT SINAI HOSPITAL (Terminated)
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Main Details
Name
THE MOUNT SINAI HOSPITAL
Subdivision Name
Center of Advanced Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330024T
Medicare Provider Number
330024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/17/2013
Last Recertification Date
12/4/2017
Termination Date
Termination Reason
7/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Mount Sinai
Michael Pastier, Senior VP/CFO - The Mount Sinai Hospital
(212) 731-3149
Primary Contact
mount sinai health system
Philip Manning, Senior Director of Pharmacy
(718) 267-4295
Addresses
Street Address
5 East 102nd Street
New York, NY 10029
Billing Address
Mount Sinai Hospital
One Gustave L. Levy Place
New York, NY 10029
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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