Provider Demographics
NPI:1053057950
Name:MARATHON VENTURES CORP
Entity Type:Organization
Organization Name:MARATHON VENTURES CORP
Other - Org Name:MARATHON MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-528-2609
Mailing Address - Street 1:21 WEST RD STE 105
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2307
Mailing Address - Country:US
Mailing Address - Phone:855-343-7799
Mailing Address - Fax:866-258-9465
Practice Address - Street 1:21 WEST RD STE 105
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2307
Practice Address - Country:US
Practice Address - Phone:855-343-7799
Practice Address - Fax:866-343-9465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies