Cumberland Family Medical Center Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Lebanon, KY

NPI 1164081923 · NPPES record last updated Sep 18, 2025

Key facts

NPI
1164081923
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
CUMBERLAND FAMILY MEDICAL CENTER INC
Practice address
3345 Highway 208
Lebanon, KY 40033-9487
Phone
(270) 692-3676
Fax
(270) 858-4029
NPI assigned
Jun 6, 2019
Organization subpart
No

Authorized official

Name
Eric E Loy, MD
Title
Ceo
Phone
(270) 858-6655

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120221000433 KY Part B Supplier - Clinic/Group Practice 6305947789 Receives reassigned benefits from 287 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

3345 Highway 208
Lebanon, KY 40033-9487

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other identifiers

IdentifierTypeStateIssuer
7100017280MedicaidKY

Other names

  • Calvary Elementary Healthy Kids Clinic Doing business as

Other providers in Lebanon, KY

All providers in Lebanon, KY · Federally Qualified Health Center (FQHC) in Kentucky

Sources for this page

Verify at the official NPI Registry.