MEDICARE: SAFE AT HOME SENIOR 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1104117993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFE AT HOME SENIOR CARE

Provider Business Mailing Address
First Line	:	3943 HIGH CHAPARRAL DR
Second Line	:
City	:	MARTINEZ
State	:	GA
Zip	:	30907-3303
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4210 COLUMBIA RD
Second Line	:
City	:	MARTINEZ
State	:	GA
Zip	:	30907-0401
Country	:	US
Telephone Number	:	706-495-6958
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	JOHN RYAN
Credential	:
Telephone Number	:	706-495-6958

Provider Enumeration Date	:	04/27/2011
Last Update Date	:	04/27/2011

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Directions to “SAFE AT HOME SENIOR CARE ” Practice Location

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