Provider Demographics
NPI:1861850315
Name:MARATHON MEDICAL SERVICE
Entity Type:Organization
Organization Name:MARATHON MEDICAL SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:APPLEBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-250-9239
Mailing Address - Street 1:4325 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5364
Mailing Address - Country:US
Mailing Address - Phone:907-250-9239
Mailing Address - Fax:907-274-9238
Practice Address - Street 1:4325 LAUREL STREET
Practice Address - Street 2:SUITE 240
Practice Address - City:ANCHORAGE
Practice Address - State:ALASKA
Practice Address - Zip Code:99508
Practice Address - Country:UM
Practice Address - Phone:907-250-9239
Practice Address - Fax:907-274-9238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-28
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies