Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands Internal Medicine - Graeca & Kruk
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
HEATHER BOLLINGER SCHNEIDER (CFO)
(814) 375-6432
Entity
Organization
Contact information
Practice address
145 HOSPITAL AVE, SUITE 215, DU BOIS, PA 15801-1462
(814) 371-1717
(814) 375-4422
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-4200
(814) 375-4232
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000423079
HIGHMARK BLUE CROSS
PA
01
—
089128
MC PTAN
PA
05
—
100774088-0225
—
PA
Enumeration date
08/11/2006
Last updated
09/08/2023
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