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DSH100012F LEE MEMORIAL HEALTH SYSTEM DBA LEE MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
LEE MEMORIAL HEALTH SYSTEM DBA LEE MEMORIAL HOSPITAL
Subdivision Name
ACCESS INFUSION
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100012F
Medicare Provider Number
100012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
3/24/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/28/2011
Last Recertification Date
8/10/2016
Termination Date
Termination Reason
10/1/2016
Other
Contacts
Authorizing Official
Lee Memorial Health System
Benjamin Spence, CFO
(239) 343-6014
Primary Contact
Lee Memorial Health System
Benjamin Spence, CFO
(239) 343-6014
Addresses
Street Address
11220-31 METRO PARKWAY
FORT MYERS, FL 33966
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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