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FQHCLA335E LEE MEMORIAL HEALTH SYSTEM (Terminated)
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Main Details
Name
LEE MEMORIAL HEALTH SYSTEM
Subdivision Name
South Fort Myers Ob/Gyn Medical Office
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-021147
340B ID
FQHCLA335E
Grant Number
LALCS00171
Additional Details
Current Program Status
Terminated
Registration Date
10/16/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/24/2017
Last Recertification Date
1/31/2022
Termination Date
Termination Reason
10/1/2022
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
9800 S. Healthpark Dr.
Suite 205
Fort Myers, FL 33908
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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