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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1265738504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXIM HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	7227 LEE DEFOREST DR
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-3236
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4341 S WESTNEDGE AVE
Second Line	:	SUITE 1201
City	:	KALAMAZOO
State	:	MI
Zip	:	49008-3289
Country	:	US
Telephone Number	:	410-910-1500
Fax Number	:

Authorized Official
Title or Position	:	CONTROLLER
Name	:	RACHEL FULLER
Credential	:
Telephone Number	:	410-910-1500

Provider Enumeration Date	:	02/03/2011
Last Update Date	:	02/03/2011

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