MEDICARE: RUFFIN & RUFFIN, LLC

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	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023021862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUFFIN & RUFFIN, LLC

Provider Business Mailing Address
First Line	:	8200 RENAISSANCE PKWY
Second Line	:	SUITE 1005
City	:	DURHAM
State	:	NC
Zip	:	27713-7747
Country	:	US
Telephone Number	:	919-361-3668
Fax Number	:	919-361-3669

Provider Business Practice Location Address
First Line	:	8200 RENAISSANCE PKWY
Second Line	:	SUITE 1005
City	:	DURHAM
State	:	NC
Zip	:	27713-7747
Country	:	US
Telephone Number	:	919-361-3668
Fax Number	:	919-361-3669

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MS. ANGENETTE R. GRANT
Credential	:	CPED 3081
Telephone Number	:	919-361-3668

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	01/12/2010

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