Provider Demographics
NPI:1124371802
Name:MAXIMED
Entity Type:Organization
Organization Name:MAXIMED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:BERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MANFRED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-257-8181
Mailing Address - Street 1:650 E PALISADE AVE
Mailing Address - Street 2:STE. 248
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-1830
Mailing Address - Country:US
Mailing Address - Phone:212-845-9244
Mailing Address - Fax:
Practice Address - Street 1:650 E PALISADE AVE
Practice Address - Street 2:STE. 248
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-1830
Practice Address - Country:US
Practice Address - Phone:212-845-9244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies