MEDICARE: STRARTING SOMEWHERE CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	405300000X	Prevention Professional

General Provider Information

NPI Number	:	1013535277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRARTING SOMEWHERE CORP

Provider Business Mailing Address
First Line	:	1626 POCA RIVER RD
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25320-7236
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1626 POCA RIVER RD
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25320-7236
Country	:	US
Telephone Number	:	304-437-9827
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	KEVEN PITSENBARGER
Credential	:
Telephone Number	:	304-437-9827

Provider Enumeration Date	:	07/13/2020
Last Update Date	:	07/13/2020

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Directions to “STRARTING SOMEWHERE CORP ” Practice Location

Language	Start Address	Practice Location

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