Organization
DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS CHARLES MEDICAL CENTER
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
MR. BRIAN S KLINE (CFO)
(814) 375-6377
Entity
Organization
Contact information
Practice address
240 ALLEGHENY BLVD, BROOKVILLE, PA 15825-2323
(814) 371-2200
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 371-2200
(814) 375-4232
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007740880070
—
PA
Enumeration date
07/23/2015
Last updated
02/29/2016
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