340B Drug Pricing Program Database
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DSH390086FF DUBOIS REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
DUBOIS REGIONAL MEDICAL CENTER
Subdivision Name
Penn Highlands Endocrinology Brookville 90610 - Endocrinology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390086FF
Medicare Provider Number
390086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/4/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/7/2019
Last Recertification Date
8/23/2023
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
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
88 Hospital Road
Brookville, PA 15825
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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