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	:	1427566587
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	:	410-910-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 ROUTE 70 STE 2002
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-6958
Country	:	US
Telephone Number	:	732-279-7960
Fax Number	:

Authorized Official
Title or Position	:	REGIONAL VP OF FINANCE
Name	:	DAVID KOWALCZYK
Credential	:
Telephone Number	:	410-910-1500

Provider Enumeration Date	:	01/11/2018
Last Update Date	:	01/11/2018

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