Healthcare Provider Details

I. General information

NPI: 1467484808
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 JAKE ALEXANDER BLVD W STE 102
SALISBURY NC
28147-1385
US

IV. Provider business mailing address

7227 LEE DEFOREST RD
COLUMBIA MD
21046-3236
US

V. Phone/Fax

Practice location:
  • Phone: 704-638-0025
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHC2970
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