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DSH330024S THE MOUNT SINAI HOSPITAL (Active)
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Main Details
Name
THE MOUNT SINAI HOSPITAL
Subdivision Name
Mt. Sinai Adolescent Health Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330024S
Medicare Provider Number
330024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/17/2013
Last Recertification Date
8/12/2024
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
320 East 94th Street
New York, NY 10128
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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May 2025
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