Provider Demographics
NPI:1285995472
Name:MARATHON MEDICAL CORPORATION
Entity type:Organization
Organization Name:MARATHON MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ST.LEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-339-4305
Mailing Address - Street 1:5715 FAIRFAX ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-3848
Mailing Address - Country:US
Mailing Address - Phone:303-339-4305
Mailing Address - Fax:303-339-4309
Practice Address - Street 1:5715 FAIRFAX ST UNIT C
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-3848
Practice Address - Country:US
Practice Address - Phone:303-339-4305
Practice Address - Fax:303-339-4309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies