340B Drug Pricing Program Database
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DSH390086GQ DUBOIS REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Integrated Recovery - Integrated Recovery DuBois
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086GQ
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/11/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/15/2024
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Penn Highlands Healthcare
Mark Norman, COO
(814) 375-6608
Primary Contact
Penn Highlands Healthcare
Mike Pasternak, 340B Compliance Manager
(814) 375-6139
Addresses
Street Address
635 Maple Ave
Floor 1
DuBois, PA 15801
Billing Address
Penn Highlands DuBois
100 Hospital Ave
DuBois, PA 15801
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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