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DUANE READE
DSH330024 THE MOUNT SINAI HOSPITAL
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Covered Entity Details
Entity Name
THE MOUNT SINAI HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330024
Entity Address
ONE GUSTAVE L. LEVY PLACE
NEW YORK, NY 10029
Medicare Provider Number
330024
Participating Start Date
7/1/2004
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
DUANE READE
Pharmacy Address
1749-53 FIRST AVE
NEW YORK, NY 10128
Pharmacy Comments
Contract Details
Approval Date
4/23/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/14/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Patricia Lamb, Chief, Ancillary Services
(212) 241-2095
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/23/2018
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