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DSH390086EL DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Interventional Pain Center Philipsburg 90780
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086EL
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/6/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/1/2016
Last Recertification Date
8/24/2018
Termination Date
Termination Reason
4/1/2019
Site closure
Contacts
Authorizing Official
Penn Highlands DuBois
Brian Kline, CFO
(814) 375-6377
Primary Contact
Penn Highlands Healthcare
Jennifer Miller, 340B Coordinator
(814) 375-6625
Addresses
Street Address
271 Railroad Street
Philipsburg, PA 16866
Billing Address
Penn Highlands DuBois
100 Hospital Avenue
PO Box 447
DuBois, PA 15801
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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