Healthcare Provider Details

I. General information

NPI: 1700413432
Provider Name (Legal Business Name): MATTHEW JOSEPH MOYER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 03/29/2025
Certification Date: 03/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 HOWARD AVE STE 403
ALTOONA PA
16601-4804
US

IV. Provider business mailing address

620 HOWARD AVE STE 403
ALTOONA PA
16601-4804
US

V. Phone/Fax

Practice location:
  • Phone: 814-283-0602
  • Fax: 814-283-0606
Mailing address:
  • Phone: 814-283-0602
  • Fax: 814-283-0606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP440986
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: