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
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	:	1902047079
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	:	410-910-1500
Fax Number	:	410-910-1600

Provider Business Practice Location Address
First Line	:	250 W MAIN ST
Second Line	:	SUITE A
City	:	SAINT CLAIRSVILLE
State	:	OH
Zip	:	43950-1070
Country	:	US
Telephone Number	:	740-526-2222
Fax Number	:	740-526-9222

Authorized Official
Title or Position	:	REGIONAL CONTROLLER
Name	:	MR. STEPHEN WALSH
Credential	:
Telephone Number	:	410-910-1500

Provider Enumeration Date	:	03/18/2009
Last Update Date	:	03/18/2009

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