Individual
DR. MATTHEW JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2907 PLEASANT VALLEY BLVD, ALTOONA, PA 16602-4305
(814) 943-8164
Mailing address
928 GOLD HILL RD, FORT MILL, SC 29708-7947
(803) 548-7197
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
13382
SC
183500000X
Pharmacist
21976
NC
1835C0207X
Compounded Sterile Preparations Pharmacist
Primary
RP455274
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21976
STATE LICENSE NUMBER
NC
01
—
PH-13382
STATE LICENSE NUMBER
SC
01
—
RP455274
STATE LICENSE NUMBER
PA
Enumeration date
07/18/2011
Last updated
07/03/2025
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