340B Drug Pricing Program Database
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DSH390086AY DUBOIS REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands General Surgery DuBois
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086AY
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/9/2012
Participating Start Date
1/1/2013
Participating Approval Date
12/14/2012
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
145 Hospital Ave
Suite 215
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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