Provider Demographics
NPI:1164292371
Name:MARATHON HEALTH LLC
Entity type:Organization
Organization Name:MARATHON HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:IMPLEMENTATION COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-869-3164
Mailing Address - Street 1:1400 WEWATTA ST STE 350
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-5553
Mailing Address - Country:US
Mailing Address - Phone:704-661-1380
Mailing Address - Fax:
Practice Address - Street 1:1125 OPAL CT STE 1004
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5934
Practice Address - Country:US
Practice Address - Phone:704-661-1380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty