Healthcare Provider Details

I. General information

NPI: 1932025947
Provider Name (Legal Business Name): MR. JERRY MICHAEL HEIN SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 GREENLEAF RD
COLUMBUS OH
43223-3824
US

IV. Provider business mailing address

1251 GREENLEAF RD
COLUMBUS OH
43223-3824
US

V. Phone/Fax

Practice location:
  • Phone: 614-207-8732
  • Fax: 614-276-8777
Mailing address:
  • Phone: 614-207-8734
  • Fax: 614-276-8777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: