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ACRO PHARMACEUTICAL SERVICES LLC
DSH330024A 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
DSH330024A
Entity Address
25-10 30TH AVENUE
LONG ISLAND CITY, NY 11102
Medicare Provider Number
330024
Outpatient Facility Provider Number
Participating Start Date
7/1/2006
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
ACRO PHARMACEUTICAL SERVICES LLC
Pharmacy Address
ACRO PHARMACEUTICAL SERVICES LLC
313 HENDERSON DR
SHARON HILL, PA 19079
Pharmacy Comments
Contract Details
Approval Date
10/11/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/27/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Philip Manning, Senior Director of Pharmacy
(718) 267-4295
Contract Pharmacy Representative
Commcare Pharmacy
Avani Patel, Client Relations Manager
(954) 284-2358
Signed By Date
10/11/2016
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