Contract Pharmacy Details

RITE AID OF KENTUCKY, INC.
CH0452070 CUMBERLAND FAMILY MEDICAL CENTER, INC.

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

RITE AID OF KENTUCKY, INC.

Pharmacy Address

RITE AID #3350
600 NORTH MAIN STREET
MUNFORDVILLE, KY 42765

Pharmacy Comments

Contract Details

Approval Date

1/11/2017

Contract Begin Date

4/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/5/2018
Ownership change

Contacts

Covered Entity Signing Official

ERIC E. LOY, CEO
(270) 864-2889

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

1/11/2017

340B Drug Pricing Program Database