Name: | CUMBERLAND FAMILY MEDICAL CENTER, INC. |
Legal type: | Kentucky Corporation |
Status: | Active |
Standing: | Good |
Profit or Non-Profit: | Non-profit |
File Date: | 27 Jun 2005 (20 years ago) |
Organization Date: | 27 Jun 2005 (20 years ago) |
Last Annual Report: | 17 Feb 2025 (25 days ago) |
Organization Number: | 0616256 |
Industry: | Health Services |
Number of Employees: | Large (100+) |
ZIP code: | 42717 |
City: | Burkesville, Bakerton, Bow, Dubre, Kettle, Peytonsbur... |
Primary County: | Cumberland County |
Principal Office: | 360 KEEN ST. - STE 500, BURKESVILLE, KY 42717-7915 |
Place of Formation: | KENTUCKY |
Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
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WXGMEK9H7K35 | 2025-02-11 | 360 KEEN ST STE 500, BURKESVILLE, KY, 42717, 7944, USA | PO BOX 1080, BURKESVILLE, KY, 42717, 7915, USA | |||||||||||||||||||||||||||||||||||||||||||||||||||
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Congressional District | 01 |
State/Country of Incorporation | KY, USA |
Activation Date | 2024-02-14 |
Initial Registration Date | 2006-10-24 |
Entity Start Date | 2005-06-28 |
Fiscal Year End Close Date | Dec 31 |
Points of Contacts
Electronic Business | |
---|---|
Title | PRIMARY POC |
Name | ERIC LOY |
Address | CUMBERLAND FAMILY MEDICAL CENTER, INC., P.O. BOX 1080, BURKESVILLE, KY, 42717, 7915, USA |
Title | ALTERNATE POC |
Name | TRACEY ANTLE |
Address | CUMBERLAND FAMILY MEDICAL CENTER, INC., P.O. BOX 1080, BURKESVILLE, KY, 42717, 1080, USA |
Government Business | |
---|---|
Title | PRIMARY POC |
Name | ERIC LOY |
Address | CUMBERLAND FAMILY MEDICAL CENTER, INC., P.O. BOX 1080, BURKESVILLE, KY, 42717, 7915, USA |
Title | ALTERNATE POC |
Name | TRACEY ANTLE |
Address | CUMBERLAND FAMILY MEDICAL CENTER, INC., P.O. BOX 1080, BURKESVILLE, KY, 42717, 1080, USA |
Past Performance | Information not Available |
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Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
CUMBERLAND FAMILY MEDICAL CENTER SAFE HARBOR 401(K) PLAN | 2013 | 203131989 | 2014-10-08 | CUMBERLAND FAMILY MEDICAL CENTER | 86 | |||||||||||||||||||||||||||||||
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Role | Plan administrator |
Date | 2014-10-08 |
Name of individual signing | DR. ERIC LOY |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2009-01-01 |
Business code | 621111 |
Sponsor’s telephone number | 2708642889 |
Plan sponsor’s address | P.O. BOX 1080, BURKESVILLE, KY, 42717 |
Signature of
Role | Plan administrator |
Date | 2013-09-26 |
Name of individual signing | DR. ERIC LOY |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2009-01-01 |
Business code | 621111 |
Sponsor’s telephone number | 2708642889 |
Plan sponsor’s address | P.O. BOX 1080, BURKESVILLE, KY, 42717 |
Plan administrator’s name and address
Administrator’s EIN | 203131989 |
Plan administrator’s name | CUMBERLAND FAMILY MEDICAL CENTER |
Plan administrator’s address | P.O. BOX 1080, BURKESVILLE, KY, 42717 |
Administrator’s telephone number | 2708642889 |
Signature of
Role | Plan administrator |
Date | 2012-08-30 |
Name of individual signing | ERIC LOY |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2009-01-01 |
Business code | 621111 |
Sponsor’s telephone number | 2708642889 |
Plan sponsor’s address | P.O. BOX 1080, BURKESVILLE, KY, 42717 |
Plan administrator’s name and address
Administrator’s EIN | 203131989 |
Plan administrator’s name | CUMBERLAND FAMILY MEDICAL CENTER |
Plan administrator’s address | P.O. BOX 1080, BURKESVILLE, KY, 42717 |
Administrator’s telephone number | 2708642889 |
Signature of
Role | Plan administrator |
Date | 2012-08-30 |
Name of individual signing | ERIC LOY |
Valid signature | Filed with authorized/valid electronic signature |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2007-07-01 |
Business code | 621111 |
Sponsor’s telephone number | 2708642889 |
Plan sponsor’s address | P.O. BOX 1080, BURKESVILLE, KY, 42717 |
Plan administrator’s name and address
Administrator’s EIN | 203131989 |
Plan administrator’s name | CUMBERLAND FAMILY MEDICAL CENTER |
Plan administrator’s address | P.O. BOX 1080, BURKESVILLE, KY, 42717 |
Administrator’s telephone number | 2708642889 |
Signature of
Role | Plan administrator |
Date | 2011-08-30 |
Name of individual signing | ERIC LOY |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2009-01-01 |
Business code | 621111 |
Sponsor’s telephone number | 2708642889 |
Plan sponsor’s address | PO BOX 1080, BURKESVILLE, KY, 42717 |
Plan administrator’s name and address
Administrator’s EIN | 203131989 |
Plan administrator’s name | CUMBERLAND FAMILY MEDICAL CENTER |
Plan administrator’s address | PO BOX 1080, BURKESVILLE, KY, 42717 |
Administrator’s telephone number | 2708642889 |
Signature of
Role | Plan administrator |
Date | 2010-07-28 |
Name of individual signing | ERIC LOY |
Valid signature | Filed with authorized/valid electronic signature |
Name | Role |
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JOSH HARDEN | Secretary |
Name | Role |
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PAULA LITTLE | Director |
ELIZABETH EVERLEY | Director |
JIM FLOWERS | Director |
GARYON SCOTT | Director |
TERRY GRIDER | Director |
LISA TARTER | Director |
LACY TERRY | Director |
ERIC LOY | Director |
FRAN HAY | Director |
DEANA LOY | Director |
Name | Role |
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KEITH RIDDLE | Vice President |
Name | Role |
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BECKY RADFORD | Treasurer |
Name | Role |
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MATHEW LEVERIDGE | Incorporator |
Name | Role |
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BRIDGET BOOHER | President |
Name | Role |
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ERIC LOY, CEO | Registered Agent |
Name | Status | Expiration Date |
---|---|---|
GLASGOW PEDIATRICS HEALTHCARE | Inactive | 2023-04-09 |
GREENSBURG HEALTHCARE | Inactive | 2023-04-09 |
Name | File Date |
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Annual Report | 2025-02-17 |
Annual Report | 2024-04-01 |
Principal Office Address Change | 2023-02-23 |
Annual Report | 2023-02-23 |
Annual Report | 2022-02-23 |
Annual Report | 2021-02-11 |
Annual Report | 2020-02-25 |
Annual Report | 2019-03-14 |
Annual Report | 2018-02-26 |
Name Renewal | 2018-02-02 |
Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
PO | AWARD | AG82A7P100041 | 2010-02-10 | 2010-06-30 | 2010-06-30 | |||||||||||||||||||
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Title | PROVIDE MEDICAL SERVICES TO PINE KNOT JCC 3/1/10 - 6/30/10 |
Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
Recipient | CUMBERLAND FAMILY MEDICAL CENTER, INC. |
UEI | WXGMEK9H7K35 |
Legacy DUNS | 786726344 |
Recipient Address | 360 KEENE ST, BURKESVILLE, 427177682, UNITED STATES |
FAIN | Awarding Agency | Assistance Listings | Start Date | End Date | Description | |||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
C12CS21817 | Department of Health and Human Services | 93.501 - AFFORDABLE CARE ACT (ACA) GRANTS FOR SCHOOL-BASED HEALTH CENTER CAPITAL EXPENDITURES | 2011-07-01 | 2013-06-30 | AFFORDABLE CARE ACT (ACA) GRANTS FOR SCHOOL-BASED HEALTH CENTERS CAPITAL PROGRAM | |||||||||||||||||||||
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C81CS13855 | Department of Health and Human Services | 93.703 - ARRA – GRANTS TO HEALTH CENTER PROGRAMS | 2009-06-29 | 2011-06-28 | ARRA - CAPITAL IMPROVEMENT PROGRAM | |||||||||||||||||||||
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H8BCS11600 | Department of Health and Human Services | 93.703 - ARRA – GRANTS TO HEALTH CENTER PROGRAMS | 2009-03-27 | 2011-03-26 | ARRA - INCREASE SERVICES TO HEALTH CENTERS | |||||||||||||||||||||
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G20RH10511 | Department of Health and Human Services | 93.912 - RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT AND SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT PROGRAM | 2008-09-01 | 2010-08-31 | SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT | |||||||||||||||||||||
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H80CS08218 | Department of Health and Human Services | 93.224 - CONSOLIDATED HEALTH CENTERS (COMMUNITY HEALTH CENTERS, MIGRANT HEALTH CENTERS, HEALTH CARE FOR THE HOMELESS, PUBLIC HOUSING PRIMARY CARE, AND SCHOOL BASED HEALTH CENTERS) | 2007-07-01 | 2015-04-30 | HEALTH CENTER CLUSTER | |||||||||||||||||||||
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Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
317642866 | 0452110 | 2015-01-21 | 404 STEVE DRIVE, RUSSELL SPRINGS, KY, 42642 | |||||||||||||||||
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Type | Inspection |
Activity Nr | 317642783 |
EIN | Type of Organization | Exempt Organization Status | Address | Ruling Date | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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20-3131989 | Corporation | Unconditional Exemption | PO BOX 1080, BURKESVILLE, KY, 42717-1080 | 2007-04 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Description | Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions. |
On Publication 78 Data List | Yes |
Deductibility | Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions) |
Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name | CUMBERLAND FAMILY MEDICAL CENTER INC |
EIN | 20-3131989 |
Tax Period | 202212 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | CUMBERLAND FAMILY MEDICAL CENTER INC |
EIN | 20-3131989 |
Tax Period | 202112 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | CUMBERLAND FAMILY MEDICAL CENTER INC |
EIN | 20-3131989 |
Tax Period | 201912 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | CUMBERLAND FAMILY MEDICAL CENTER INC |
EIN | 20-3131989 |
Tax Period | 201812 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | CUMBERLAND FAMILY MEDICAL CENTER INC |
EIN | 20-3131989 |
Tax Period | 201712 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | CUMBERLAND FAMILY MEDICAL CENTER INC |
EIN | 20-3131989 |
Tax Period | 201612 |
Filing Type | E |
Return Type | 990 |
File | View File |
Organization Name | CUMBERLAND FAMILY MEDICAL CENTER INC |
EIN | 20-3131989 |
Tax Period | 201512 |
Filing Type | E |
Return Type | 990 |
File | View File |
Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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1956148802 | 2021-04-11 | 0457 | PPP | 404 Steve Dr, Russell Springs, KY, 42642-4622 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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USDOT Number | Carrier Operation | MCS-150 Form Date | MCS-150 Mileage | MCS-150 Year | Power Units | Drivers | Operation Classification | |||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
2309285 | Intrastate Non-Hazmat | 2012-05-24 | - | - | 1 | 1 | Auth. For Hire | |||||||||||||||||||||||||||||||||||||||||||||||||||
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Total Number of Inspections for the measurement period (24 months) | 0 |
Driver Fitness BASIC Serious Violation Indicator | No |
Vehicle Maintenance BASIC Acute/Critical Indicator | No |
Unsafe Driving BASIC Acute/Critical Indicator | No |
Driver Fitness BASIC Roadside Performance measure value | 0 |
Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value | 0 |
Total Number of Driver Inspections for the measurment period | 0 |
Vehicle Maintenance BASIC Roadside Performance measure value | 0 |
Total Number of Vehicle Inspections for the measurement period | 0 |
Controlled Substances and Alcohol BASIC Roadside Performance measure value | 0 |
Unsafe Driving BASIC Roadside Performance Measure Value | 0 |
Number of inspections with at least one Driver Fitness BASIC violation | 0 |
Number of inspections with at least one Hours-of-Service BASIC violation | 0 |
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation | 0 |
Number of inspections with at least one Vehicle Maintenance BASIC violation | 0 |
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation | 0 |
Number of inspections with at least one Controlled Substances and Alcohol BASIC violation | 0 |
Number of inspections with at least one Unsafe Driving BASIC violation | 0 |
Sources: Kentucky Secretary of State