Provider Demographics
NPI:1043554595
Name:SAFE HOME PRO, INC.
Entity type:Organization
Organization Name:SAFE HOME PRO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:LASARSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-604-5317
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28070-0725
Mailing Address - Country:US
Mailing Address - Phone:704-948-4125
Mailing Address - Fax:336-419-4511
Practice Address - Street 1:18635 STARCREEK DR
Practice Address - Street 2:SUITE B
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-9341
Practice Address - Country:US
Practice Address - Phone:704-948-4125
Practice Address - Fax:336-419-4511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-23
Last Update Date:2012-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC02011332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies