Healthcare Provider Details

I. General information

NPI: 1619883378
Provider Name (Legal Business Name): BRIAN JAVORSKY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

962 S DORSET RD
TROY OH
45373-4705
US

IV. Provider business mailing address

6360 OAK TRAIL DR
GALLOWAY OH
43119-7530
US

V. Phone/Fax

Practice location:
  • Phone: 800-232-4239
  • Fax: 800-982-9148
Mailing address:
  • Phone: 614-579-1867
  • Fax: 800-982-9148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03127564
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: