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FQHCLA335A LEE MEMORIAL HEALTH SYSTEM (Terminated)
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Main Details
Name
LEE MEMORIAL HEALTH SYSTEM
Subdivision Name
P.L. Dunbar Medical Office
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-014713
340B ID
FQHCLA335A
Grant Number
LALCS00171
Additional Details
Current Program Status
Terminated
Registration Date
4/9/2015
Participating Start Date
7/1/2015
Participating Approval Date
4/22/2015
Last Recertification Date
1/31/2022
Termination Date
Termination Reason
4/1/2023
Other
Contacts
Authorizing Official
Lee Community Healthcare
Robert Johns, Executive Director for Lee Community Healthcare
(239) 834-9998
Primary Contact
Lee Health
Joseph Bitner, Compliance Officer
(239) 343-8602
Addresses
Street Address
3511 Dr. Martin Luther King, Jr. Boulevard
Fort Myers, FL 33916-4651
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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