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TOTAL CARE RX, INC.
DSH330169 MOUNT SINAI BETH ISRAEL
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Covered Entity Details
Entity Name
MOUNT SINAI BETH ISRAEL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330169
Entity Address
FIRST AVENUE AT 16TH STREET
NEW YORK, NY 10003
Medicare Provider Number
330169
Participating Start Date
7/1/2005
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
TOTAL CARE RX, INC.
Pharmacy Address
WORLD'S FAIR PHARMACY
22310 UNION TPKE
OAKLAND GARDENS, NY 11364-3645
Pharmacy Comments
Contract Details
Approval Date
7/14/2021
Contract Begin Date
7/21/2021
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
Total Care Rx
Benedict L Ho, Compliance Officer
(718) 762-7111
Signed By Date
7/14/2021
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