Provider Demographics
NPI:1023021862
Name:RUFFIN & RUFFIN, LLC
Entity type:Organization
Organization Name:RUFFIN & RUFFIN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGENETTE
Authorized Official - Middle Name:R
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:CPED 3081
Authorized Official - Phone:919-361-3668
Mailing Address - Street 1:8200 RENAISSANCE PKWY
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7747
Mailing Address - Country:US
Mailing Address - Phone:919-361-3668
Mailing Address - Fax:919-361-3669
Practice Address - Street 1:8200 RENAISSANCE PKWY
Practice Address - Street 2:SUITE 1005
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7747
Practice Address - Country:US
Practice Address - Phone:919-361-3668
Practice Address - Fax:919-361-3669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704866Medicaid
NC7704866Medicaid