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DSH390086FC DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands General Surgery Punxsy 90640
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086FC
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/3/2018
Participating Start Date
10/1/2018
Participating Approval Date
7/31/2018
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
551 W. Mahoning St.
Punxsutawney, PA 15767
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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