Provider Demographics
NPI:1710202486
Name:MAXIM HEALTHCARE SERVICES
Entity type:Organization
Organization Name:MAXIM HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-324-6421
Mailing Address - Street 1:1500 W FOURTH AVENUE
Mailing Address - Street 2:501
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201
Mailing Address - Country:US
Mailing Address - Phone:509-324-6421
Mailing Address - Fax:509-324-8002
Practice Address - Street 1:1500 W 4TH AVE
Practice Address - Street 2:501
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-7257
Practice Address - Country:US
Practice Address - Phone:509-324-6421
Practice Address - Fax:509-324-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601407644251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health