Provider Demographics
NPI:1528944733
Name:JOHNSTOWN FREE MEDICAL CLINIC
Entity type:Organization
Organization Name:JOHNSTOWN FREE MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANCHANKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-534-6242
Mailing Address - Street 1:315 LOCUST ST STE 2
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1651
Mailing Address - Country:US
Mailing Address - Phone:814-534-6242
Mailing Address - Fax:814-534-6731
Practice Address - Street 1:225 S CENTER AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2033
Practice Address - Country:US
Practice Address - Phone:814-443-5867
Practice Address - Fax:814-534-6731
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHNSTOWN FREE MEDICAL CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty