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CH045207EG CUMBERLAND FAMILY MEDICAL CENTER, INC. (Active)
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Main Details
Name
CUMBERLAND FAMILY MEDICAL CENTER, INC.
Subdivision Name
Pine Knot Primary Healthy Kids Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-028154
340B ID
CH045207EG
Grant Number
H80CS08218
Additional Details
Current Program Status
Active
Registration Date
10/3/2019
Participating Start Date
1/1/2020
Participating Approval Date
11/15/2019
Last Recertification Date
2/20/2025
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
119 E KY 2792
Pine Knot, KY 42635
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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