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FQHCLA335B LEE MEMORIAL HEALTH SYSTEM (Terminated)
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Main Details
Name
LEE MEMORIAL HEALTH SYSTEM
Subdivision Name
Cape Coral Medical Office
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-016848
340B ID
FQHCLA335B
Grant Number
LALCS00171
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/2/2016
Last Recertification Date
1/29/2024
Termination Date
Termination Reason
1/1/2025
Business decision by the Covered Entity
Contacts
Authorizing Official
Lee Health
Rachel Suzanne Walter, System Director, FQHC-LA
(239) 823-5840
Primary Contact
Lee Health
Joseph Bitner, Compliance Officer
(239) 343-8602
Addresses
Street Address
1435 SE 8th Terrace
Cape Coral, FL 33990
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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