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CH04168W FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. (Active)
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Main Details
Name
FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Subdivision Name
Bonita Springs Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013776
340B ID
CH04168W
Grant Number
H80CS00185
Additional Details
Current Program Status
Active
Registration Date
7/14/2014
Participating Start Date
10/1/2014
Participating Approval Date
7/22/2014
Last Recertification Date
3/4/2025
Contacts
Authorizing Official
Family Health Centers of Southwest Florida, Inc.
Carrie Poulsom, VP & Chief Pharmacy Officer
(239) 344-2321
Primary Contact
Family Health Centers of SWFL Inc
Crystal Lancon, Pharmacy Compliance Administrator
(239) 344-2315
Addresses
Street Address
11921 Saradrienne Ln
Bonita Springs, FL 34135-5911
Billing Address
Family Health Centers of Southwest Florida
PO BOX 1357
FORT MYERS, FL 33902
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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