Provider Demographics
NPI:1740643212
Name:HOMEREACH
Entity type:Organization
Organization Name:HOMEREACH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VP REGIONAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:HERBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-544-4066
Mailing Address - Street 1:5450 FRANTZ RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4135
Mailing Address - Country:US
Mailing Address - Phone:614-566-0850
Mailing Address - Fax:
Practice Address - Street 1:3800 OLENTANGY RIVER RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3455
Practice Address - Country:US
Practice Address - Phone:614-566-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-01
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0185226Medicaid
OH0593900002Medicare NSC