Provider Demographics
NPI:1871815092
Name:MAYNARD HEALTH ACCESS AND CONSULTING CORPORATION
Entity Type:Organization
Organization Name:MAYNARD HEALTH ACCESS AND CONSULTING CORPORATION
Other - Org Name:MAYHAC CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEREESE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAYNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-570-1786
Mailing Address - Street 1:4800 HAMILTON AVE
Mailing Address - Street 2:STE 2B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-3825
Mailing Address - Country:US
Mailing Address - Phone:443-570-1786
Mailing Address - Fax:866-579-6016
Practice Address - Street 1:4800 HAMILTON AVE
Practice Address - Street 2:STE 2B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-3825
Practice Address - Country:US
Practice Address - Phone:443-570-1786
Practice Address - Fax:866-579-6016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty