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NPI Code Detail

MEDICARE: MAXIM HEALTHCARE SERVICES, INC.

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
1251E00000XHome Health Agency80000381CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417910126
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAXIM HEALTHCARE SERVICES, INC.
Provider Business Mailing Address
First Line : 7227 LEE DEFOREST DRIVE
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-3405
Country : US
Telephone Number : 410-910-1500
Fax Number : 410-910-1600
Provider Business Practice Location Address
First Line : 3111 CAMINO DEL RIO N STE 1200
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-5747
Country : US
Telephone Number : 619-299-9350
Fax Number :
Authorized Official
Title or Position : CONTROLLER
Name : DAVID KOWALCZYK
Credential :
Telephone Number : 410-910-1500
Provider Enumeration Date : 04/11/2006
Last Update Date : 06/21/2021

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SAN DIEGO, CA
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Practice Fax:
1982318911 — ARTINA JEAN SCHOENEN LVN
Practice Location Address:
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Practice Fax:
1447949771 — MAXIM HEALTHCARE SERVICES, INC.
Practice Location Address:
3111 CAMINO DEL RIO N STE 1200
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Practice Fax:

Directions to “MAXIM HEALTHCARE SERVICES, INC. ” Practice Location

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