Healthcare Provider Details
I. General information
NPI: 1588087308
Provider Name (Legal Business Name): PHARMACY4HUMANITY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/30/2014
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2880 W CYPRESS CREEK RD
FORT LAUDERDALE FL
33309-1737
US
IV. Provider business mailing address
18421 S MAIN ST
GARDENA CA
90248-4609
US
V. Phone/Fax
- Phone: 855-894-6337
- Fax: 954-761-4539
- Phone: 310-999-6089
- Fax: 833-261-3712
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PHY007002-NR |
| License Number State | LA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KENNETH SCOTT
CARRUTHERS
Title or Position: CHIEF OF PHARMACY
Credential:
Phone: 310-999-6089