MEDICARE: TRUSTED LIFE CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1235390089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUSTED LIFE CARE

Provider Business Mailing Address
First Line	:	1425 GREENWAY DR
Second Line	:	STE 300
City	:	IRVING
State	:	TX
Zip	:	75038-2486
Country	:	US
Telephone Number	:	972-539-6060
Fax Number	:	317-791-9139

Provider Business Practice Location Address
First Line	:	6447 S EAST ST
Second Line	:	STE C
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-2118
Country	:	US
Telephone Number	:	317-585-9137
Fax Number	:	317-791-9139

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	WILLIAM J GUIDETTI SR.
Credential	:
Telephone Number	:	469-499-2876

Provider Enumeration Date	:	06/24/2008
Last Update Date	:	01/10/2011

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