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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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1649845587
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 :
Fax Number :
Provider Business Practice Location Address
First Line : 900 VIRGINIA ST E STE 400
Second Line :
City : CHARLESTON
State : WV
Zip : 25301-2835
Country : US
Telephone Number : 681-313-4759
Fax Number :
Authorized Official
Title or Position : CONTROLLER
Name : DAVID KOWALCZYK
Credential :
Telephone Number : 410-910-1500
Provider Enumeration Date : 05/24/2021
Last Update Date : 10/07/2022

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Directions to “MAXIM HEALTHCARE SERVICES, INC ” Practice Location

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