Provider Demographics
NPI:1164475539
Name:YOUR HOMETOWN FOOT CARE INC
Entity Type:Organization
Organization Name:YOUR HOMETOWN FOOT CARE INC
Other - Org Name:PORTSMOUTH FOOT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DPM OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:GREINER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:740-353-6911
Mailing Address - Street 1:820 CHILLICOTHE ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4028
Mailing Address - Country:US
Mailing Address - Phone:740-353-6911
Mailing Address - Fax:740-353-2950
Practice Address - Street 1:820 CHILLICOTHE ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-4028
Practice Address - Country:US
Practice Address - Phone:740-353-6911
Practice Address - Fax:740-353-2950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2054351Medicaid
OH2054351Medicaid
OH1025620001Medicare NSC
OHCL1653 RAILROADMedicare PIN