| John B Fruits | |
|
11 W Commerce St Smyrna DE 19977-1463 | |
| (302) 599-7717 | |
| Not Available |
| Full Name | John B Fruits |
|---|---|
| Speciality | Counselor |
| Location | 11 W Commerce St, Smyrna, Delaware |
| Authorized Official Name and Position | John B Fruits (OWNER) |
| Authorized Official Contact | 3025596212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John B Fruits 11 W Commerce St Smyrna DE 19977-1463 Ph: () - | John B Fruits 11 W Commerce St Smyrna DE 19977-1463 Ph: (302) 599-7717 |
| NPI Number | 1447025861 |
|---|---|
| Provider Enumeration Date | 11/15/2023 |
| Last Update Date | 11/15/2023 |
| Certification Date | 11/15/2023 |
| Medicare PECOS PAC ID | 5092165001 |
|---|---|
| Medicare Enrollment ID | O20240103000029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447025861 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | John B Fruits |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750164513 PECOS PAC ID: 6901256916 Enrollment ID: I20240103000032 |
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