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CLINTON COUNTY PHARMACY
CH0452070 CUMBERLAND FAMILY MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
CUMBERLAND FAMILY MEDICAL CENTER, INC.
Subdivision Name
CUMBERLAND FAMILY MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH0452070
Entity Address
360 KEEN STREET
BURKESVILLE, KY 42717
Grant Number
H80CS08218
Participating Start Date
1/1/2008
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
CLINTON COUNTY PHARMACY
Pharmacy Address
903 N CROSS ST
ALBANY, KY 42602-1617
Pharmacy Comments
Contract Details
Approval Date
1/14/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/2/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Eric Loy, CEO
(270) 864-2889
Contract Pharmacy Representative
Clinton County Pharmacy
Bobby Huff, Pharmacist, Co-Owner
(606) 688-3113
Signed By Date
1/14/2020
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