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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 Agency524HHA-12NV

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 : 1366523532
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
Country : US
Telephone Number : 410-910-1500
Fax Number : 410-910-1600
Provider Business Practice Location Address
First Line : 3930 HOWARD HUGHES PKWY STE 300
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-0946
Country : US
Telephone Number : 702-560-2192
Fax Number :
Authorized Official
Title or Position : CONTROLLER
Name : DAVID KOWALCZYK
Credential :
Telephone Number : 410-910-1500
Provider Enumeration Date : 10/17/2006
Last Update Date : 03/02/2023

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

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