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CAREMARK FLORIDA SPECIALTY PHARMACY LLC
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
CAREMARK FLORIDA SPECIALTY PHARMACY LLC
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
7930 WOODLAND CENTER BLVD STE 500
TAMPA, FL 33614
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
4/20/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Pastier, Senior VP/CFO - The Mount Sinai Hospital
(212) 731-3149
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2020
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