Organization
MARATHON DPC, LLC
Active
Other names
Carpenters Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES VAN EVERY (MANAGER CENTRAL SUPPORT)
(408) 406-9645
Entity
Organization
Contact information
Practice address
1403 HAMPTON AVENUE, ST. LOUIS, MO 63139
(314) 955-9355
Mailing address
1403 HAMPTON AVENUE, ST. LOUIS, MO 63139
(314) 955-2179
(314) 955-2180
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
04/02/2019
Last updated
05/22/2025
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