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FQHCLA335Z Lee Memorial Health System (Terminated)
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Main Details
Name
Lee Memorial Health System
Subdivision Name
Adult Gastroenterology Office
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-034507
340B ID
FQHCLA335Z
Grant Number
LALCS00171
Additional Details
Current Program Status
Terminated
Registration Date
1/5/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/5/2023
Last Recertification Date
Termination Date
Termination Reason
10/1/2023
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
16410 Healthpark Commons Dr
Fort Myers, FL 33908-9621
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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