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CH045207CL CUMBERLAND FAMILY MEDICAL CENTER, INC. (Terminated)
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Main Details
Name
CUMBERLAND FAMILY MEDICAL CENTER, INC.
Subdivision Name
Thomas Nelson High Healthy Kids Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-022248
340B ID
CH045207CL
Grant Number
H80CS08218
Additional Details
Current Program Status
Terminated
Registration Date
8/30/2018
Participating Start Date
10/1/2018
Participating Approval Date
9/5/2018
Last Recertification Date
1/31/2020
Termination Date
Termination Reason
1/1/2021
Site closure
Contacts
Authorizing Official
Cumberland Family Medical Center
Eric Loy, CEO
(270) 864-2889
Primary Contact
Cumberland Family Medical Center
Mona Staton, Director of 340B Services
(270) 864-2889
Addresses
Street Address
150 Generals Blvd
Bardstown, KY 40004-6504
Billing Address
Cumberland Family Medical Center
404 Steve Drive
PO Box 2399
Russell Springs, KY 42642
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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