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RUSSELL SPRINGS PHARMACY
CH045207B CUMBERLAND FAMILY MEDICAL CENTER, INC.
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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
RUSSELL SPRINGS PHARMACY
Pharmacy Address
92 JOE T PETTY DR
RUSSELL SPRINGS, KY 42642
Pharmacy Comments
Contract Details
Approval Date
10/11/2013
Contract Begin Date
1/1/2014
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
Sherie Loy-Helm, Pharmacist
(270) 866-2778
Signed By Date
10/11/2013
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