MEDICARE: MAXIM HEALTHCARE SERVICES, INC.

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	251E00000X	Home Health Agency	13-1393	OR

General Provider Information

NPI Number	:	1407071939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXIM HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	7227 LEE DEFOREST RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-3236
Country	:	US
Telephone Number	:	410-910-1500
Fax Number	:	410-910-1600

Provider Business Practice Location Address
First Line	:	1600 VALLEY RIVER DR
Second Line	:	SUITE 210
City	:	EUGENE
State	:	OR
Zip	:	97401-2129
Country	:	US
Telephone Number	:	541-242-0628
Fax Number	:	541-242-0636

Authorized Official
Title or Position	:	REGIONAL CONTROLLER
Name	:	MR. CHRISTOPHER RATHAMANN
Credential	:
Telephone Number	:	410-910-1500

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	08/22/2020

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