MEDICARE: MAXIM HEALTH CARE SERVICES

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
1	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1073755112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXIM HEALTH CARE SERVICES

Provider Business Mailing Address
First Line	:	6856 EASTERN AVE NW # STU220
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-2165
Country	:	US
Telephone Number	:	202-545-6980
Fax Number	:	202-545-9081

Provider Business Practice Location Address
First Line	:	6856 EASTERN AVE NW # STU220
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-2165
Country	:	US
Telephone Number	:	202-545-6980
Fax Number	:	202-545-9081

Authorized Official
Title or Position	:	ADMINSTRATOR
Name	:	DARNELL JENKINS
Credential	:
Telephone Number	:	202-545-6980

Provider Enumeration Date	:	04/06/2009
Last Update Date	:	04/06/2009

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