Healthcare Provider Details
I. General information
NPI: 1164339735
Provider Name (Legal Business Name): CUMBERLAND FAMILY MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
830 CUMBERLAND TRACE RD
BOWLING GREEN KY
42103-9015
US
IV. Provider business mailing address
PO BOX 2399
RUSSELL SPRINGS KY
42642-2399
US
V. Phone/Fax
- Phone: 844-435-0900
- Fax: 270-858-4029
- Phone: 270-858-6655
- Fax: 270-858-4027
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QF0400X |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ERIC
E
LOY
Title or Position: CEO
Credential: MD
Phone: 270-858-6655