Organization
FAMILY HEALTH CENTERS
Active
Other names
FAMILY HEALTH CENTER PHARMACY BROADWAY
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL RIDDICK (CEO)
(502) 774-8631
Entity
Organization
Contact information
Practice address
834 E BROADWAY, LOUISVILLE, KY 40204-1072
(502) 290-2828
(502) 290-2974
Mailing address
PO BOX 950244, LOUISVILLE, KY 40295-0244
(502) 774-8631
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07622
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147053
PK
—
05
—
7100323800
—
KY
Enumeration date
08/07/2014
Last updated
05/07/2026
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