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DSH390086DF DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Obstetrics Carnevale - Clearfield 93350
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086DF
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
Termination Date
Termination Reason
7/1/2015
For-Profit conversion
Contacts
Authorizing Official
Penn Highlands DuBois
Brian Kline, CFO
(814) 375-6377
Primary Contact
Lauri Schall, 340B Coordinator
(814) 375-3762
Addresses
Street Address
807 Turnpike Avenue
Suite 260
Clearfield, PA 16830-1239
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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