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CH04170G COLLIER HEALTH SERVICES, INC. (Active)
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Main Details
Name
COLLIER HEALTH SERVICES, INC.
Subdivision Name
RONALD MCDONALD CARE MOBILE
Type
HRSA-Funded Health Center
Site ID
BPS-H80-007372
340B ID
CH04170G
Grant Number
H80CS00735
Additional Details
Current Program Status
Active
Registration Date
7/1/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/6/2015
Last Recertification Date
2/18/2025
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
Immokalee, FL 34142-2200
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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