Provider Demographics
NPI:1306334339
Name:RUFFIN ENTERPRISE LLC
Entity type:Organization
Organization Name:RUFFIN ENTERPRISE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:
Authorized Official - Last Name:RUFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-851-0672
Mailing Address - Street 1:7438 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4200
Mailing Address - Country:US
Mailing Address - Phone:985-851-0672
Mailing Address - Fax:
Practice Address - Street 1:7438 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4200
Practice Address - Country:US
Practice Address - Phone:985-851-0672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOC-26011343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)