Organization
DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS FAMILY MED EMPORIUM
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands DuBois
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
BRIAN KLINE (CFO)
(814) 788-8580
Entity
Organization
Contact information
Practice address
275 E 4TH ST, EMPORIUM, PA 15834-1411
(814) 788-8580
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100774088
—
PA
Enumeration date
07/22/2015
Last updated
07/22/2015
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