340B Drug Pricing Program Database
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DSH390086CY DUBOIS REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Pediatrics GRAH/MAR/SOR - Clearfield 93260
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086CY
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
3/11/2024
Participating Start Date
4/1/2024
Participating Approval Date
3/12/2024
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
1033 Turnpike Avenue
Suite 200
Clearfield, PA 16830-3061
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2015, terminated 7/1/2015. Reinstated 4/1/2024.
03/11/2024
April 2025
April 2025
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