340B Drug Pricing Program Database
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DSH330024AJ THE MOUNT SINAI HOSPITAL (Active)
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Main Details
Name
THE MOUNT SINAI HOSPITAL
Subdivision Name
Mount Sinai Staten Island Cancer
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330024AJ
Medicare Provider Number
330024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/13/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/25/2023
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
1441 South Avenue
Suites 206 & 207
Staten Island, NY 10314
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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