Healthcare Provider Details

I. General information

NPI: 1366900458
Provider Name (Legal Business Name): DUBOIS REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W MAIN ST
RIDGWAY PA
15853-1611
US

IV. Provider business mailing address

4 RAILROAD ST
SAINT MARYS PA
15857-1798
US

V. Phone/Fax

Practice location:
  • Phone: 814-371-2000
  • Fax:
Mailing address:
  • Phone: 814-834-7915
  • Fax: 814-834-6510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOURDAN STRISHOCK
Title or Position: DIRECTOR
Credential:
Phone: 814-375-6160