MEDICARE: MAXMED HEALTHCARE, 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	008735	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497895171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXMED HEALTHCARE, INC

Provider Business Mailing Address
First Line	:	PO BOX 592240
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78259-0161
Country	:	US
Telephone Number	:	210-599-3233
Fax Number	:	210-579-6654

Provider Business Practice Location Address
First Line	:	506 E RAMSEY RD
Second Line	:	SUITE 1
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-4657
Country	:	US
Telephone Number	:	210-599-3233
Fax Number	:	210-579-6654

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. OLUSEGUN OYEWOLE
Credential	:
Telephone Number	:	210-979-7805

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	01/30/2012

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Directions to “MAXMED HEALTHCARE, INC ” Practice Location

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