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CH04170AH COLLIER HEALTH SERVICES INC (Active)
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Main Details
Name
COLLIER HEALTH SERVICES INC
Subdivision Name
Healthcare Network Van Domelen Health Express
Type
HRSA-Funded Health Center
Site ID
BPS-H80-039567
340B ID
CH04170AH
Grant Number
H80CS00735
Additional Details
Current Program Status
Active
Registration Date
1/10/2025
Participating Start Date
4/1/2025
Participating Approval Date
1/13/2025
Last Recertification Date
Contacts
Authorizing Official
Collier Health Services, Inc., d/b/a Healthcare Network
John Fletcher, Chief Operating Officer & General Counsel
(239) 658-3060
Primary Contact
Collier Health Services, Inc.
Martine Woolley, Vice President of Pharmacy
(239) 658-3030
Addresses
Street Address
1454 Madison Ave W UNIT 3
Immokalee, FL 34142
Billing Address
Collier Health Services, Inc., d/b/a Healthcare Network
1454 Madison Ave W
Immokalee, FL 34142
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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