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	253Z00000X	In Home Supportive Care Agency
2	385H00000X	Respite Care
3	251E00000X	Home Health Agency	20674096	FL

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902912512
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	:	6301 NW 5TH WAY
Second Line	:	SUITE 5010
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-6131
Country	:	US
Telephone Number	:	954-977-9958
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VP OF FINANCE
Name	:	DAVID KOWALCZYK
Credential	:
Telephone Number	:	410-910-1730

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	03/10/2025

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