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NPI Code Detail

MEDICARE: MARATHON HEALTH, LLC

MEDICARE: MARATHON HEALTH, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1154154383
Entity Type Code : Organization
Provider Name (Legal Business Name) : MARATHON HEALTH, LLC
Provider Business Mailing Address
First Line : 10 W MARKET ST STE 2900
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46204-2964
Country : US
Telephone Number : 866-434-3255
Fax Number :
Provider Business Practice Location Address
First Line : 10 W MARKET ST STE 2900
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46204-2964
Country : US
Telephone Number : 866-434-3255
Fax Number :
Authorized Official
Title or Position : CEO
Name : JEFF WELLS
Credential : MD
Telephone Number : 866-434-3255
Provider Enumeration Date : 08/22/2024
Last Update Date : 08/22/2024

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