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CH045207EF CUMBERLAND FAMILY MEDICAL CENTER, INC. (Active)
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Main Details
Name
CUMBERLAND FAMILY MEDICAL CENTER, INC.
Subdivision Name
Pine Knot Intermediate Healthy Kids Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-028155
340B ID
CH045207EF
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
2/18/2025
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
6519 S Highway 1651
Pine Knot, KY 42635-9162
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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