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HOMETOWN PHARMACY OF CAMPBELLSVILLE, PLL
CH045207GL Cumberland Family Medical Center, Inc.
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Covered Entity Details
Entity Name
Cumberland Family Medical Center, Inc.
Subdivision Name
Taylor County Primary Healthy Kids Clinic
Type
HRSA-Funded Health Center
340B ID
CH045207GL
Entity Address
106 Ingram Ave
Campbellsville, KY 42718-1621
Grant Number
H80CS08218
Participating Start Date
1/1/2023
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
HOMETOWN PHARMACY OF CAMPBELLSVILLE, PLL
Pharmacy Address
325 E BROADWAY ST
CAMPBELLSVILLE, KY 42718
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ryan Smith, CFO
(270) 858-6655
Contract Pharmacy Representative
Hometown Pharmacy Specialty Services
MeLeigha Milby, CEO
(270) 937-9008
Signed By Date
1/15/2025
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