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CH04170Y COLLIER HEALTH SERVICES, INC. (Terminated)
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Main Details
Name
COLLIER HEALTH SERVICES, INC.
Subdivision Name
Children's Care West
Type
HRSA-Funded Health Center
Site ID
BPS-H80-022240
340B ID
CH04170Y
Grant Number
H80CS00735
Additional Details
Current Program Status
Terminated
Registration Date
11/26/2018
Participating Start Date
1/1/2019
Participating Approval Date
12/7/2018
Last Recertification Date
1/28/2020
Termination Date
Termination Reason
4/1/2021
Business decision by the Covered Entity
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
1008 Goodlette-Frank Rd STE 100
Naples, FL 34102-5406
Billing Address
Collier Health Services, Inc., d/b/a Healthcare Network of Southwest Florida
1454 Madison Ave W
Immokalee, FL 34142
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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May 2025
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