Organization
MARATHON HEALTH, LLC
Active
Parent organization
MARATHON HEALTH, LLC
Other names
Marathon Health at Brevard South
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARATHON HEALTH, LLC
Authorized official
JERRY FORD (CEO)
(802) 857-0400
Entity
Organization
Contact information
Practice address
2550 WINGATE BOULEVARD, C/O BREVARD WELLCARE- SOUTH, WEST MELBOURNE, FL 32904
(802) 857-0400
Mailing address
20 WINOOSKI FALLS WAY STE 400, WINOOSKI, VT 05404-2239
(802) 857-0434
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/28/2017
Last updated
02/28/2017
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