Healthcare Provider Details

I. General information

NPI: 1184579658
Provider Name (Legal Business Name): PHARMACY4HUMANITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 W 50TH ST
NEW YORK NY
10019-6592
US

IV. Provider business mailing address

18421 S MAIN ST
GARDENA CA
90248-4609
US

V. Phone/Fax

Practice location:
  • Phone: 212-284-0056
  • Fax:
Mailing address:
  • Phone: 310-999-6089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KENNETH SCOTT CARRUTHERS
Title or Position: CHIEF OF PHARMACY
Credential:
Phone: 310-999-6089