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ELY DRUGS INC. # 2
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
ELY DRUGS INC. # 2
Pharmacy Address
415 HAPPY VALLEY RD
GLASGOW, KY 42141
Pharmacy Comments
Contract Details
Approval Date
7/15/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/25/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
ERIC E. LOY, CEO
(270) 864-2889
Contract Pharmacy Representative
Ely Drugs
Travis Hudnall, Pharmacist, Owner/Operator
(270) 651-8359
Signed By Date
7/15/2016
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