| Marathon Dpc, Llc | |
|
1403 Hampton Avenue St. Louis MO 63139 | |
| (314) 955-9355 | |
| Not Available |
| Full Name | Marathon Dpc, Llc |
|---|---|
| Speciality | Pharmacy |
| Location | 1403 Hampton Avenue, St. Louis, Missouri |
| Authorized Official Name and Position | Charles Van Every (MANAGER CENTRAL SUPPORT) |
| Authorized Official Contact | 4084069645 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marathon Dpc, Llc 1403 Hampton Avenue St. Louis MO 63139 Ph: (314) 955-2179 | Marathon Dpc, Llc 1403 Hampton Avenue St. Louis MO 63139 Ph: (314) 955-9355 |
| NPI Number | 1013479716 |
|---|---|
| Provider Enumeration Date | 04/02/2019 |
| Last Update Date | 05/22/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013479716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 333600000X | Pharmacy | (* (Not Available)) | Primary |
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