Healthcare Provider Details

I. General information

NPI: 1295924199
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3065 WILLIAM ST SUITE 101
CAPE GIRARDEAU MO
63703-6393
US

IV. Provider business mailing address

7227 LEE DEFOREST DR
COLUMBIA MD
21046-3236
US

V. Phone/Fax

Practice location:
  • Phone: 573-332-8842
  • Fax: 573-332-8068
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 Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN P WALSH
Title or Position: REGIONAL CONTROLLER
Credential:
Phone: 410-910-1500