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DSH390056Q JC BLAIR MEMORIAL HOSPITAL (dba PENN HIGHLANDS HUNTINGDON) (Active)
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Main Details
Name
JC BLAIR MEMORIAL HOSPITAL (dba PENN HIGHLANDS HUNTINGDON)
Subdivision Name
PH Radiology State College - Radiology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390056Q
Medicare Provider Number
390056
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/6/2025
Participating Start Date
4/1/2025
Participating Approval Date
2/12/2025
Last Recertification Date
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
239 COLONNADE BLVD
STATE COLLEGE, PA 16803
Billing Address
PH Huntingdon
1225 Warm Springs Ave.
Huntingdon, PA 16652
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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