Provider Demographics
NPI:1649084930
Name:BIRTHSIDE BEGINNINGS
Entity type:Organization
Organization Name:BIRTHSIDE BEGINNINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GENNETTE
Authorized Official - Middle Name:RUTHERFOORD
Authorized Official - Last Name:HUBER, LM, CPM
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:757-234-9654
Mailing Address - Street 1:167 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:SURRY
Mailing Address - State:VA
Mailing Address - Zip Code:23883-2444
Mailing Address - Country:US
Mailing Address - Phone:757-234-9654
Mailing Address - Fax:
Practice Address - Street 1:3552 COLLINS BLVD STE D
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5264
Practice Address - Country:US
Practice Address - Phone:757-234-9654
Practice Address - Fax:757-734-9954
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASCALON NATUROPATHIC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30018125220001Medicaid