340B Drug Pricing Program Database
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CH045207HA Cumberland Family Medical Center, Inc. (Active)
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Main Details
Name
Cumberland Family Medical Center, Inc.
Subdivision Name
Otter Creek Academy Healthy Kids Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-035895
340B ID
CH045207HA
Grant Number
H80CS08218
Additional Details
Current Program Status
Active
Registration Date
2/28/2023
Participating Start Date
4/1/2023
Participating Approval Date
3/1/2023
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
1440 Old Bethel Church Rd
Alpha, KY 42633-6204
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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