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FQHCLA335AJ Lee Memorial Health System (Terminated)
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Main Details
Name
Lee Memorial Health System
Subdivision Name
Permanent Site - Dunbar Medical Office
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-036294
340B ID
FQHCLA335AJ
Grant Number
LALCS00171
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2023
Participating Start Date
7/1/2023
Participating Approval Date
4/11/2023
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
3637 Dr Martin Luther King Jr Blvd
Fort Myers, FL 33916
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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