Healthcare Provider Details

I. General information

NPI: 1356459747
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 EAST COLISEUM BLVD. SUITE 300
FT. WAYNE IN
46805
US

IV. Provider business mailing address

7227 LEE DEFOREST DRIVE
COLUMBIA MD
21046
US

V. Phone/Fax

Practice location:
  • Phone: 260-432-1166
  • Fax: 260-436-3914
Mailing address:
  • Phone: 410-910-1500
  • Fax: 410-910-1600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number003757-1
License Number StateIN

VIII. Authorized Official

Name: MR. DUANE D BRICKHOUSE
Title or Position: VP OF FINANCE
Credential:
Phone: 410-910-1500