Healthcare Provider Details

I. General information

NPI: 1104855857
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 10/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2634 CHAPEL HILL BLVD. SUITE 210
DURHAM NC
27707
US

IV. Provider business mailing address

7227 LEE DEFOREST RD
COLUMBIA MD
21046-3236
US

V. Phone/Fax

Practice location:
  • Phone: 919-419-1484
  • Fax: 919-419-1681
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 NumberHC1269
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

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