NPIMap

Organization Active NPI

Marathon Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Melbourne, FL
National Provider Identifier
1033412903
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
60 4021 Issued in FL
Legal business name
MARATHON HEALTH, INC.
Practice address
1110 W Hibiscus Blvd
Melbourne, FL 32901-2704
Phone
(321) 309-0565
Fax
(321) 309-0567
NPI assigned
Dec 14, 2010
Organization subpart
Yes
Parent organization
MARATHON HEALTH, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jerry M Ford
Title
Ceo
Phone
(802) 857-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 60 4021 FL Primary

Addresses

Primary practice location

1110 W Hibiscus Blvd
Melbourne, FL 32901-2704

Mailing address

354 Mountain View Dr
Suite 300
Colchester, VT 05446-5968
Phone (802) 857-0400

Other names 1

  • Marathon Health at DRS w. Hibiscus Other name

National Provider Directory

National Provider Directory
Tax ID family
Marathon Health LLC130 organizations share this tax ID, including this one
Part of
Marathon Health LLC

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

1110 W Hibiscus Blvd
Melbourne, FL 32901
Phone (321) 309-0565

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1033412903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 MOUNTAIN VIEW DR",
            "address_2": "SUITE 300",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054465968",
            "telephone_number": "802-857-0400",
            "fax_number": "802-655-3607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W HIBISCUS BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012704",
            "telephone_number": "321-309-0565",
            "fax_number": "321-309-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARATHON HEALTH, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARATHON HEALTH, INC.",
        "enumeration_date": "2010-12-14",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "802-857-0400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "60 4021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marathon Health at DRS w. Hibiscus",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.