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General NPI Number Information
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NPI Number | 1700520855
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Entity Type | Organization
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Legal Business Name | JOHNSTOWN FREE MEDICAL CLINIC
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Dates
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Enumeration Date | 04/25/2022
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 315 LOCUST STREET, 2ND FLOOR JOHNSTOWN, PA 15901
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City | JOHNSTOWN
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State | PA
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Zip | 15901
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Country | US
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Telephone | 814-534-6242
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Fax | 814-534-6731
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Provider Business Mailing Address
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Address Line | 315 LOCUST ST STE 2
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City | JOHNSTOWN
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State | PA
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Zip | 15901-1651
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Country | US
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Telephone | 814-534-6242
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Fax | 814-534-6731
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ROSALIE DANCHANKO
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Credential |
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Telephone | 814-534-6242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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