Healthcare Provider Details

I. General information

NPI: 1962768754
Provider Name (Legal Business Name): RENAL CARE CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 OSBORNE ST
JOHNSTOWN PA
15905-4146
US

IV. Provider business mailing address

88 OSBORNE ST
JOHNSTOWN PA
15905-4146
US

V. Phone/Fax

Practice location:
  • Phone: 814-539-0798
  • Fax: 814-536-4751
Mailing address:
  • Phone: 814-539-0798
  • Fax: 814-536-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License NumberDN002166
License Number StatePA

VIII. Authorized Official

Name: GEORGE FREM
Title or Position: CEO
Credential: MD
Phone: 814-244-9873