MEDICARE: MAX HEALTHCARE SERVICES

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

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	:	1831480599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAX HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	2151 E DUBLIN GRANVILLE RD
Second Line	:	SUITE 215
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3519
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2151 E DUBLIN GRANVILLE RD
Second Line	:	SUITE 215
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3519
Country	:	US
Telephone Number	:	614-423-8585
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	YVONNE FOMENKY
Credential	:
Telephone Number	:	614-423-8585

Provider Enumeration Date	:	04/28/2011
Last Update Date	:	04/28/2011

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Directions to “MAX HEALTHCARE SERVICES ” Practice Location

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