340B Drug Pricing Program Database
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DSH390086AM DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Family Medicine Ridgway 94275
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086AM
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
12/14/2012
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
123 South Street
Ridgway, PA 15853
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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