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General NPI Number Information
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NPI Number | 1417064049
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Entity Type | Organization
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Legal Business Name | MAXIM HEALTHCARE SERVICES, INC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 303 S FLORIDA AVE
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City | LAKELAND
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State | FL
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Zip | 33801-4623
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Country | US
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Telephone | 863-683-2699
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Fax |
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Provider Business Mailing Address
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Address Line | 7227 LEE DEFOREST DR
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City | COLUMBIA
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State | MD
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Zip | 21046-3236
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGIONAL VP OF FINANCE
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Name | KATHY JACKSON
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Credential |
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Telephone | 410-910-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 21668096
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License Number State | FL
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