Contract Pharmacy Details

WALGREEN CO.
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

WALGREEN CO.

Pharmacy Address

RITE AID #03939
101 EASTWOOD SHOPPING CTR
FRANKFORT, KY 40601

Pharmacy Comments

Contract Details

Approval Date

2/9/2018

Contract Begin Date

2/14/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/15/2019
Pharmacy closed

Contacts

Covered Entity Signing Official

Eric Loy, CEO
(270) 864-2889

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

2/9/2018

340B Drug Pricing Program Database