Provider Demographics
NPI:1104355247
Name:FRUX INC
Entity type:Organization
Organization Name:FRUX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:KEECH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:252-362-3141
Mailing Address - Street 1:105 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-4923
Mailing Address - Country:US
Mailing Address - Phone:252-362-3141
Mailing Address - Fax:
Practice Address - Street 1:105 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-4923
Practice Address - Country:US
Practice Address - Phone:252-362-9092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-11
Last Update Date:2018-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty