340B Drug Pricing Program Database
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DSH330024C THE MOUNT SINAI HOSPITAL (Terminated)
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Main Details
Name
THE MOUNT SINAI HOSPITAL
Subdivision Name
MOUNT SINAI QUEENS INFUSION
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330024C
Medicare Provider Number
330024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/17/2013
Last Recertification Date
8/12/2024
Termination Date
Termination Reason
1/1/2025
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
Samuel Wilhelm-Ross, 340B Program Director
(646) 605-2006
Addresses
Street Address
27-15 30th Avenue
Long Island City, NY 11102
Billing Address
Mount Sinai Hospital-Mount Sinai Hospital of Queens
25-10 30th Av
Long Island City, NY 11102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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