Organization
LIFE FLUIDS INC
Active
Other names
Ken's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KEN M JERKINS (PRESIDENT)
(561) 585-4679
Entity
Organization
Contact information
Practice address
101 N FEDERAL HWY, LAKE WORTH, FL 33460-3435
(561) 585-4679
(561) 588-8562
Mailing address
101 N FEDERAL HWY, LAKE WORTH, FL 33460-3435
(561) 585-4679
(561) 588-8562
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
11721
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1072468
NABP NUMBER
FL
Enumeration date
06/12/2006
Last updated
08/22/2020
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