340B Drug Pricing Program Database
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DSH330046Q MOUNT SINAI WEST (Active)
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Main Details
Name
MOUNT SINAI WEST
Subdivision Name
ST. LUKE'S GENERAL CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330046Q
Medicare Provider Number
330046
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/13/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/19/2016
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
158 W 124th St
New York, NY 10027
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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