Organization Name: | CUMBERLAND FAMILY MEDICAL CENTER INC |
NPI Number: | 1538550991 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ERIC E LOY (CEO) |
Mailing Address: | 1409 S Highway 76 Russell Springs |
State: | KY US |
Postal Code: | 426429612 |
Phone Number: | 2708666197 |
Fax Number: | 2708641693 |
NPI Enumeration Date: | 02/06/2015 |
NPI Last Update Date: | 06/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | 700172 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |