MEDICARE: JAVON PARKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	ST588821	OH

General Provider Information

NPI Number	:	1831997766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAVON PARKER

Provider Business Mailing Address
First Line	:	2410 HOME ACRE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-1647
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2410 HOME ACRE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-1647
Country	:	US
Telephone Number	:	614-439-2823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2025
Last Update Date	:	03/05/2025

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Directions to “ JAVON PARKER ” Practice Location

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