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DSH390086C DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Internal Medicine DuBois 90570
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086C
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/17/2012
Last Recertification Date
11/14/2017
Termination Date
Termination Reason
4/1/2018
Site closure
Contacts
Authorizing Official
Penn Highlands DuBois
Brian Kline, CFO
(814) 375-6377
Primary Contact
Penn Highlands Healthcare
Jessica Strini, 340B Coordinator
(814) 375-6553
Addresses
Street Address
145 Hospital Avenue
Suite 205
DuBois, PA 15801
Billing Address
Penn Highlands DuBois
100 Hospital Ave
PO Box 447
DuBois, PA 15801
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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