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DSH390086DQ DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Family Medicine St Marys 94250
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086DQ
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
9/12/2022
Termination Date
Termination Reason
7/1/2023
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Penn Highlands Healthcare
Heather B Schneider, System CFO
(814) 375-6432
Primary Contact
Penn Highlands Healthcare
Mike Pasternak, 340B Compliance Manager
(814) 375-6139
Addresses
Street Address
761 Johnsonburg Road
Suite 240
St. Marys, PA 15857-1440
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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