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DSH100012AP LEE HEALTH SYSTEM, INC. DBA LEE HEALTH (Active)
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Main Details
Name
LEE HEALTH SYSTEM, INC. DBA LEE HEALTH
Subdivision Name
THE SANCTUARY OUTPATIENT CENTER - Pain/Spine Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100012AP
Medicare Provider Number
100012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/8/2019
Participating Start Date
10/1/2019
Participating Approval Date
9/3/2019
Last Recertification Date
8/18/2024
Contacts
Authorizing Official
Lee Memorial Health System
Benjamin Spence, CFO
(239) 343-6014
Primary Contact
Lee Memorial Health System
Joseph Bitner, Compliance Officer
(239) 343-8602
Addresses
Street Address
8960 Colonial Center Drive
Suite 210 (Pain/Spine clinic)
Fort Myers, FL 33905
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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