MEDICARE: PHARMACY4HUMANITY

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	3336S0011X	Specialty Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PH19401	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2015763	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386695302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACY4HUMANITY

Provider Business Mailing Address
First Line	:	18421 S MAIN ST
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90248-4609
Country	:	US
Telephone Number	:	310-999-6089
Fax Number	:	833-261-3712

Provider Business Practice Location Address
First Line	:	2 SHIRCLIFF WAY STE 900
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4753
Country	:	US
Telephone Number	:	904-389-9744
Fax Number	:	904-389-9406

Authorized Official
Title or Position	:	CHIEF OF PHARMACY
Name	:	KENNETH SCOTT CARRUTHERS
Credential	:
Telephone Number	:	310-999-6089

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	02/13/2026

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Directions to “PHARMACY4HUMANITY ” Practice Location

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