340B Drug Pricing Program Database
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DSH330024V THE MOUNT SINAI HOSPITAL (Active)
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Main Details
Name
THE MOUNT SINAI HOSPITAL
Subdivision Name
JACKSON HEIGHTS EXTENSION CLINIC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330024V
Medicare Provider Number
330024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/14/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/24/2017
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
37-22 82nd Street
Jackson Heights, NY 11372
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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