Provider Demographics
NPI:1215194196
Name:TRUSTED LIFE CARE INC
Entity Type:Organization
Organization Name:TRUSTED LIFE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUIDETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-499-2857
Mailing Address - Street 1:1425 GREENWAY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2447
Mailing Address - Country:US
Mailing Address - Phone:469-499-5249
Mailing Address - Fax:
Practice Address - Street 1:1000 HURRICANE SHOALS RD NE
Practice Address - Street 2:BLDG B, STE 800
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-4826
Practice Address - Country:US
Practice Address - Phone:770-237-8440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4175040007Medicare NSC
MA4175040001Medicare NSC