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DSH390086EU DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Diabetes and Nutrition Wellness Center Clearfield 78200
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086EU
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/10/2018
Last Recertification Date
9/8/2021
Termination Date
Termination Reason
4/1/2022
Site closure
Contacts
Authorizing Official
Penn Highlands DuBois
Brian Kline, CFO
(814) 375-6377
Primary Contact
Penn Highlands Healthcare
Bailey Voelker, 340B Coordinator
(814) 375-6625
Addresses
Street Address
809 Turnpike Ave
Suite 220
Clearfield, PA 16830
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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