Healthcare Provider Details

I. General information

NPI: 1457217374
Provider Name (Legal Business Name): KENDALL FERRARA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2498 2ND LOOP RD
FLORENCE SC
29501-6162
US

IV. Provider business mailing address

2498 2ND LOOP RD
FLORENCE SC
29501-6162
US

V. Phone/Fax

Practice location:
  • Phone: 843-317-1233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number60286
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: