Organization
PRODIGY DIALYSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE JOSEPH FREM MD (MEDICAL DIRECTOR)
(814) 539-0798
Entity
Organization
Contact information
Practice address
105 METZLER ST, JOHNSTOWN, PA 15904-3124
(814) 539-0798
(814) 536-4751
Mailing address
105 METZLER ST, JOHNSTOWN, PA 15904-3124
(814) 539-0798
(814) 536-4751
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
MD042825E
PA
Other
Enumeration date
10/23/2006
Last updated
02/05/2013
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