Basic Information
| Provider Information | |||||||||
| NPI: | 1396892006 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HOME SAFE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5914 JET PORT INDUSTRIAL BLVD | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336345158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138908809 | ||||||||
| FaxNumber: | 8138908819 | ||||||||
| Practice Location | |||||||||
| Address1: | 5914 JET PORT INDUSTRIAL BLVD | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336345158 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138908809 | ||||||||
| FaxNumber: | 8138908819 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GULLO | ||||||||
| AuthorizedOfficialFirstName: | GLENN | ||||||||
| AuthorizedOfficialMiddleName: | J. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8138908809 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | CPA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 1313117 | FL | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.