# MARATHON HEALTH, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARATHON HEALTH, INC.
- **Other names:** Marathon Health at Brevard Central
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1356883771
- **Legal business name:** MARATHON HEALTH, INC.
- **Authorized official:** JERRY FORD (CEO)
- **Authorized official phone:** (802) 857-0400

## Contact information

- **Practice address:** 2694 JUDGE FRAN JAMIESON WAY, C/O BREVARD WELLCARE- CENTRAL, MELBOURNE, FL 32940
- **Practice address phone:** (321) 252-1169
- **Practice address fax:** (321) 989-0316
- **Mailing address:** 20 WINOOSKI FALLS WAY STE 400, WINOOSKI, VT 05404-2239
- **Mailing address phone:** (802) 857-0400
- **Mailing address fax:** (802) 419-4876

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/16/2016
- **Last updated:** 11/16/2016