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DSH390086BP DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Integrated Primary Care 71130
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086BP
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2013
Participating Start Date
4/1/2013
Participating Approval Date
1/10/2013
Last Recertification Date
8/27/2014
Termination Date
Termination Reason
7/1/2015
Site closure
Contacts
Authorizing Official
Penn Highlands DuBois
Brian Kline, CFO
(814) 375-6377
Primary Contact
Patricia Cressley, CFO
(814) 375-6299
Addresses
Street Address
100 Caldwell Drive
DuBois, PA 15801
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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