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DSH390056D JC BLAIR MEMORIAL HOSPITAL (dba PENN HIGHLANDS HUNTINGDON) (Terminated)
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Main Details
Name
JC BLAIR MEMORIAL HOSPITAL (dba PENN HIGHLANDS HUNTINGDON)
Subdivision Name
JCB Palliative Care - Palliative Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390056D
Medicare Provider Number
390056
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2024
Participating Start Date
4/1/2024
Participating Approval Date
3/6/2024
Last Recertification Date
8/12/2024
Termination Date
Termination Reason
1/1/2025
Business decision by the Covered Entity
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
1227 Warm Springs Ave.
Suite 202
Huntingdon, PA 16652
Billing Address
Penn Highlands Huntingdon
1225 Warm Springs Ave.
Huntingdon, PA 16652
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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