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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 Agency20000480CA

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 : 1417054867
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 : 1900 ALAMEDA DE LAS PULGAS
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-1222
Country : US
Telephone Number : 650-286-1245
Fax Number : 866-224-7327
Authorized Official
Title or Position : REGIONAL CONTROLLER
Name : DAVID KOWALCZYK
Credential :
Telephone Number : 410-910-1500
Provider Enumeration Date : 09/20/2006
Last Update Date : 07/02/2009

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

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