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DSH390086CU DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Pediatrics St Marys 94310
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086CU
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2015
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
761 Johnsonburg Rd
Suite 340
St Marys, PA 15857
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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