MEDICARE: KABAFUSION SC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3336C0003X	Community/Retail Pharmacy
2	3336S0011X	Specialty Pharmacy
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	333600000X	Pharmacy
5	3336H0001X	Home Infusion Therapy Pharmacy

General Provider Information

NPI Number	:	1992599351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KABAFUSION SC, LLC

Provider Business Mailing Address
First Line	:	17777 CENTER COURT DR N STE 550
Second Line	:
City	:	CERRITOS
State	:	CA
Zip	:	90703-9337
Country	:	US
Telephone Number	:	800-435-3020
Fax Number	:

Provider Business Practice Location Address
First Line	:	5955 CORE RD STE 512
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-6085
Country	:	US
Telephone Number	:	888-211-7439
Fax Number	:	854-999-4977

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	DR. TINA BENKENDORFER
Credential	:	PHARM. D.
Telephone Number	:	800-435-3020

Provider Enumeration Date	:	04/08/2025
Last Update Date	:	04/08/2025

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