MEDICARE: MAXIM HEALTHCARE

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	HHA4602	DC

General Provider Information

NPI Number	:	1518360023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXIM HEALTHCARE

Provider Business Mailing Address
First Line	:	4012 FOX GATE LN
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-9357
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4012 FOX GATE LN
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-9357
Country	:	US
Telephone Number	:	202-421-6272
Fax Number	:

Authorized Official
Title or Position	:	HOME HEALTH AIDE
Name	:	TERRYL RICHARDSON
Credential	:
Telephone Number	:	202-421-6272

Provider Enumeration Date	:	09/29/2014
Last Update Date	:	09/29/2014

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Directions to “MAXIM HEALTHCARE ” Practice Location

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