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
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1891639142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARATHON HEALTH LLC

Provider Business Mailing Address
First Line	:	PO BOX 1433
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03802-1433
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2304 CENTURY CENTER BLVD
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-4906
Country	:	US
Telephone Number	:	972-721-8107
Fax Number	:

Authorized Official
Title or Position	:	CENTRAL SUPPORT SPECIALIST
Name	:	KARLA SPIVEY
Credential	:
Telephone Number	:	866-434-3255

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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Directions to “MARATHON HEALTH LLC ” Practice Location

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