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DSH390086BT DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Internal Medicine Ridgway 94271
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086BT
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2014
Participating Start Date
4/1/2014
Participating Approval Date
2/11/2014
Last Recertification Date
9/13/2019
Termination Date
Termination Reason
10/1/2020
Site closure
Contacts
Authorizing Official
Penn Highlands DuBois
Brian Kline, CFO
(814) 375-6377
Primary Contact
Penn Highlands Healthcare
Bailey Voelker, 340B Coordinator
(814) 375-6625
Addresses
Street Address
99 Hospital 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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