MEDICARE: CUMBERLAND HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	SP0550707	WV

General Provider Information

NPI Number	:	1316018195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUMBERLAND HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 418
Second Line	:
City	:	IAEGER
State	:	WV
Zip	:	24844-0418
Country	:	US
Telephone Number	:	304-938-2819
Fax Number	:	304-938-5501

Provider Business Practice Location Address
First Line	:	4381 COAL HERITAGE RD
Second Line	:
City	:	IAEGER
State	:	WV
Zip	:	24844-0418
Country	:	US
Telephone Number	:	304-938-2819
Fax Number	:	304-938-5501

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	DR. JENNIFER NICOLE JONES
Credential	:	PHARM, D.
Telephone Number	:	304-938-2819

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	10/06/2022

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