Organization
PRODIGY DIALYSIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE J FREM MD (CEO/MEDICAL DIRECTOR)
(814) 539-0798
Entity
Organization
Contact information
Practice address
211 GEORGIAN PL, SOMERSET, PA 15501-1610
(814) 443-1600
(814) 443-1601
Mailing address
88 OSBORNE ST, JOHNSTOWN, PA 15905-4146
(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
04/23/2009
Last updated
01/10/2014
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