Organization
FAMILY HEALTH CENTER PHARMACY
Active
Organization
FAMILY HEALTH CENTER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL RIDDICK (CEO)
(502) 774-8631
Entity
Organization
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(502) 774-8631
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1810894
NCPDP
—
05
—
54006044
—
KY
01
—
P01226
STATE LICENSE
KY
Enumeration date
10/25/2006
Last updated
05/07/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up