Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands Family Medicine Continuity Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
BRIAN S KLINE (VP/CFO, AUTHORIZED OFFICIAL)
(814) 375-6377
Entity
Organization
Contact information
Practice address
145 HOSPITAL AVE STE 315, DU BOIS, PA 15801
(814) 503-4305
(814) 503-4307
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-4200
(814) 375-4217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007740880070
—
PA
01
—
106218
MC
PA
Enumeration date
06/12/2018
Last updated
06/19/2018
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