Healthcare Provider Details

I. General information

NPI: 1548297054
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CENTREPORT DR STE 300
GREENSBORO NC
27409-9434
US

IV. Provider business mailing address

7227 LEE DEFOREST RD
COLUMBIA MD
21046-3236
US

V. Phone/Fax

Practice location:
  • Phone: 336-852-3148
  • Fax:
Mailing address:
  • Phone: 410-910-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC1334
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
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: DAVID KOWALCZYK
Title or Position: EXECUTIVE VP OF FINANCE
Credential:
Phone: 410-910-1730