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DSH100034E MOUNT SINAI MEDICAL CENTER (Active)
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Main Details
Name
MOUNT SINAI MEDICAL CENTER
Subdivision Name
Mount Sinai Medical Center - Outpatient Behavioral Health Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100034E
Medicare Provider Number
100034
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2019
Participating Start Date
1/1/2020
Participating Approval Date
12/1/2019
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Mount Sinai Medical Center
ANGEL PALLIN, SVP OF OPERATIONS
(305) 674-2520
Primary Contact
Mount Sinai Medical Center
ANA CAROLINA CALDERA, DIRECTOR OF PHARMACY
(305) 674-2855
Addresses
Street Address
4302 Alton Road
Suite 500
Miami Beach, FL 33140
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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