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WALGREEN CO.
CH045207GB CUMBERLAND FAMILY MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
CUMBERLAND FAMILY MEDICAL CENTER, INC.
Subdivision Name
Frankfort High Healthy Kids Clinic
Type
HRSA-Funded Health Center
340B ID
CH045207GB
Entity Address
328 Shelby St
Frankfort, KY 40601-2859
Grant Number
H80CS08218
Participating Start Date
4/1/2022
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09856
385 VERSAILLES RD
FRANKFORT, KY 40601
Pharmacy Comments
Contract Details
Approval Date
10/5/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ryan Smith, CFO
(270) 858-6655
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/5/2023
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