340B Drug Pricing Program Database
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DSH390086DX DUBOIS REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands General Surgery St Marys
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086DX
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/11/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/19/2016
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
761 Johnsonburg Rd
Suite 240
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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