| Epsdt | |
|
1086 Franklin St Johnstown PA 15905-4305 | |
| (814) 534-1821 | |
| (814) 534-1743 |
| Full Name | Epsdt |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1086 Franklin St, Johnstown, Pennsylvania |
| Authorized Official Name and Position | Jean A Dziagwa (DIRECTOR PFS) |
| Authorized Official Contact | 8144108296 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Epsdt 1086 Franklin St Johnstown PA 15905 Ph: (814) 410-8296 | Epsdt 1086 Franklin St Johnstown PA 15905-4305 Ph: (814) 534-1821 |
| NPI Number | 1396822425 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 04/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396822425 | NPI | - | NPPES |
| 1004907 | Other | PA | GATEWAY EPSDT |
| 1007568490053 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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