Healthcare Provider Details

I. General information

NPI: 1619898079
Provider Name (Legal Business Name): JOSHUA PLAVKO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 MATTHEW ST
MARIETTA OH
45750-1635
US

IV. Provider business mailing address

279 MUSKINGUM DR APT 206
MARIETTA OH
45750-1447
US

V. Phone/Fax

Practice location:
  • Phone: 740-434-0588
  • Fax:
Mailing address:
  • Phone: 937-515-3827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03226312
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: