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DSH330024L THE MOUNT SINAI HOSPITAL (Active)
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Main Details
Name
THE MOUNT SINAI HOSPITAL
Subdivision Name
PS 108
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330024L
Medicare Provider Number
330024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/8/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/10/2019
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
1615 Madison Avenue
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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Participating start date 1/1/2014; Terminated 11/1/2017; Reinstated 4/1/2019.
01/08/2019
May 2025
May 2025
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