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CH045207Q CUMBERLAND FAMILY MEDICAL CENTER, INC. (Terminated)
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Main Details
Name
CUMBERLAND FAMILY MEDICAL CENTER, INC.
Subdivision Name
Whitley Family Medical Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-014819
340B ID
CH045207Q
Grant Number
H80CS08218
Additional Details
Current Program Status
Terminated
Registration Date
7/9/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/20/2015
Last Recertification Date
2/15/2022
Termination Date
Termination Reason
4/1/2023
Other
Contacts
Authorizing Official
Cumberland Family Medical Center
Ryan Smith, CFO
(270) 858-6655
Primary Contact
Cumberland Family Medical Center
Mona Staton, Director of 340B Services
(270) 864-2889
Addresses
Street Address
19 MEDICAL LOOP # 3
WHITLEY CITY, KY 42653-4382
Billing Address
Cumberland Family Medical Center
PO Box 2399
Russell Springs, KY 42642
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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