Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Other names
Means Lauf Super Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BENNETT (OPERATIONS DIRECTOR)
(814) 299-7553
Entity
Organization
Contact information
Practice address
265 ALLEGHENY BLVD, BROOKVILLE, PA 15825-2321
(814) 849-7504
(814) 849-6332
Mailing address
265 ALLEGHENY BLVD, BROOKVILLE, PA 15825-2321
(814) 849-7504
(814) 849-6332
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PP411543L
PA
3336L0003X
Long Term Care Pharmacy
PP411543L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030215900001
—
PA
01
—
2153295
PK
—
Enumeration date
08/31/2006
Last updated
08/30/2022
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