MEDICARE: HOME SAFE, LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies	1313117	FL

General Provider Information

NPI Number	:	1396892006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME SAFE, LLC

Provider Business Mailing Address
First Line	:	5914 JET PORT INDUSTRIAL BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5158
Country	:	US
Telephone Number	:	813-890-8809
Fax Number	:	813-890-8819

Provider Business Practice Location Address
First Line	:	5914 JET PORT INDUSTRIAL BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-5158
Country	:	US
Telephone Number	:	813-890-8809
Fax Number	:	813-890-8819

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GLENN J. GULLO
Credential	:	CPA
Telephone Number	:	813-890-8809

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	08/22/2020

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