Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands Pathology
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
MR. BRIAN S KLINE (VP & CFO)
(814) 375-6377
Entity
Organization
Contact information
Practice address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-3238
(814) 375-3585
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-3238
(814) 375-3585
Taxonomy
Speciality
Code
Description
License number
State
207ZC0006X
Clinical Pathology Physician
—
—
207ZC0500X
Cytopathology Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
207ZH0000X
Hematology (Pathology) Physician
—
—
207ZI0100X
Immunopathology Physician
—
—
207ZN0500X
Neuropathology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000035613
BLUE CROSS/BLUE SHIELD
PA
05
—
1007740880070
—
PA
Enumeration date
09/20/2006
Last updated
12/10/2019
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