MEDICARE: MAXWELL MEDICAL 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	332BC3200X	Customized Equipment (DME)	0040222	TX
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	0040222	TX
3	332B00000X	Durable Medical Equipment & Medical Supplies	0040222	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720034275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXWELL MEDICAL SERVICES, INC

Provider Business Mailing Address
First Line	:	506 E RAMSEY RD STE 1
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-4657
Country	:	US
Telephone Number	:	210-340-2217
Fax Number	:	210-855-7884

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	:	210-340-2217
Fax Number	:	210-855-7884

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. LANDON GROFF
Credential	:
Telephone Number	:	210-340-2217

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	03/09/2022

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Directions to “MAXWELL MEDICAL SERVICES, INC ” Practice Location

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