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NPI Code Detail

MEDICARE: MAXIM HEALTHCARE SERVICES, INC.

MEDICARE: MAXIM HEALTHCARE SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency20000462CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003849886
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAXIM HEALTHCARE SERVICES, INC.
Provider Business Mailing Address
First Line : 7227 LEE DEFOREST DRIVE
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-3405
Country : US
Telephone Number : 410-910-1500
Fax Number : 410-910-1600
Provider Business Practice Location Address
First Line : 2000 POWELL ST STE 900
Second Line :
City : EMERYVILLE
State : CA
Zip : 94608-1888
Country : US
Telephone Number : 510-982-3773
Fax Number :
Authorized Official
Title or Position : REGIONAL CONTROLLER
Name : MR. DAVID S. KOWALCZYK
Credential :
Telephone Number : 410-910-1730
Provider Enumeration Date : 07/08/2006
Last Update Date : 08/30/2022

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Directions to “MAXIM HEALTHCARE SERVICES, INC. ” Practice Location

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