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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
1253Z00000XIn Home Supportive Care Agency
2385H00000XRespite Care
3251J00000XNursing Care Agency
4251E00000XHome Health Agency1010213IL

General Provider Information

NPI Number : 1639272768
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 : 11 EXECUTIVE DR STE 1
Second Line :
City : FAIRVIEW HEIGHTS
State : IL
Zip : 62208-1357
Country : US
Telephone Number : 618-628-7551
Fax Number :
Authorized Official
Title or Position : VP OF FINANCE
Name : DAVID KOWALCZYK
Credential :
Telephone Number : 410-910-1500
Provider Enumeration Date : 09/06/2006
Last Update Date : 10/16/2025

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