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CH04168D FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. (Active)
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Main Details
Name
FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Subdivision Name
FORT MYERS CENTER - DOWNTOWN
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004883
340B ID
CH04168D
Grant Number
H80CS00185
Additional Details
Current Program Status
Active
Registration Date
4/1/1995
Participating Start Date
4/1/1995
Participating Approval Date
3/25/2005
Last Recertification Date
3/4/2025
Contacts
Authorizing Official
Family Health Centers of Southwest Florida, Inc.
Carrie Poulsom, VP & Chief Pharmacy Officer
(239) 344-2321
Primary Contact
Family Health Centers of SWFL Inc
Crystal Lancon, Pharmacy Compliance Administrator
(239) 344-2315
Addresses
Street Address
2232 GRAND AVE
FORT MYERS, FL 33901-3717
Billing Address
Family Health Centers of SW Florida, Inc
P.O. Box 1357
Fort Myers, FL 33902
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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2/15/12 - Added bill to address and changed AO from LALAI HAMRIC and contact name from Beverly Nugent. 3/1/05 - EDIT ZIP CODE FROM 33901 TO 33902
02/15/2012
3/1/05 - EDIT ZIP CODE FROM 33901 TO 33902
03/25/2005
May 2025
May 2025
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