Healthcare Provider Details

I. General information

NPI: 1013535277
Provider Name (Legal Business Name): STRARTING SOMEWHERE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 07/13/2020
Certification Date: 07/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 POCA RIVER RD
CHARLESTON WV
25320-7236
US

IV. Provider business mailing address

1626 POCA RIVER RD
CHARLESTON WV
25320-7236
US

V. Phone/Fax

Practice location:
  • Phone: 304-437-9827
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: KEVEN PITSENBARGER
Title or Position: CEO/OWNER
Credential:
Phone: 304-437-9827