340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LAKE CUMBERLAND PHARMACY #2
CH045207B CUMBERLAND FAMILY MEDICAL CENTER, INC.
Print
Covered Entity Details
Entity Name
CUMBERLAND FAMILY MEDICAL CENTER, INC.
Subdivision Name
Russell Family Medical Center
Type
HRSA-Funded Health Center
340B ID
CH045207B
Entity Address
404 Steve Dr
Russell Springs, KY 42642
Grant Number
H80CS08218
Participating Start Date
7/1/2010
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
LAKE CUMBERLAND PHARMACY #2
Pharmacy Address
124 DOWELL ROAD
RUSSELL SPRINGS, KY 42642
Pharmacy Comments
Contract Details
Approval Date
3/18/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
ERIC E. LOY, CEO
(270) 864-2889
Contract Pharmacy Representative
Russell County Hospital
Jonathan Grider, Managing Member
(270) 858-6400
Signed By Date
1/14/2013
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session