Healthcare Provider Details

I. General information

NPI: 1629802327
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 JEFFERSON ST NE STE A
ALBUQUERQUE NM
87113-1734
US

IV. Provider business mailing address

8300 JEFFERSON ST NE STE A
ALBUQUERQUE NM
87113-1734
US

V. Phone/Fax

Practice location:
  • Phone: 410-910-1500
  • Fax:
Mailing address:
  • Phone: 55-542-3131
  • Fax:

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
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID KOWALCZYK
Title or Position: EXECUTIVE VP OF FINANCE
Credential:
Phone: 410-910-1500