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DSH390086CH DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Gastroenterology Clearfield 93370
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086CH
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/6/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/5/2015
Last Recertification Date
8/10/2016
Termination Date
Termination Reason
7/1/2017
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
531 Hannah Street
Clearfield, PA 16830
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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