Healthcare Provider Details

I. General information

NPI: 1699494849
Provider Name (Legal Business Name): OWEN HOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2022
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 PLEASANT VALLEY BLVD
ALTOONA PA
16602-4803
US

IV. Provider business mailing address

2613 WILLIAM PENN AVE
JOHNSTOWN PA
15909-1147
US

V. Phone/Fax

Practice location:
  • Phone: 814-949-6414
  • Fax:
Mailing address:
  • Phone: 814-254-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP459509
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: