Organization
MEADVILLE AREA FREE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELYN A JOHNSON (OFFICE MANAGER)
(814) 337-7166
Entity
Organization
Contact information
Practice address
216 CHESTNUT STREET, MEADVILLE, PA 16335
(814) 337-7166
(814) 337-7167
Mailing address
PO BOX 1363, MEADVILLE, PA 16335
(814) 337-7166
(814) 337-7167
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14568
BUREAU OF CHARITABLE ORGA
PA
Enumeration date
01/10/2007
Last updated
08/22/2020
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