Healthcare Provider Details

I. General information

NPI: 1962421941
Provider Name (Legal Business Name): DUBOIS REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 MAPLE AVE
DU BOIS PA
15801-2376
US

IV. Provider business mailing address

100 HOSPITAL AVE
DU BOIS PA
15801-1440
US

V. Phone/Fax

Practice location:
  • Phone: 814-375-6351
  • Fax: 814-372-2682
Mailing address:
  • Phone: 814-375-6351
  • Fax: 814-372-2682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number135501
License Number StatePA

VIII. Authorized Official

Name: HEATHER SCHNEIDER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 814-375-6432