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CH04168AH FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC. (Active)
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Main Details
Name
FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.
Subdivision Name
The Salvation Army
Type
HRSA-Funded Health Center
Site ID
BPS-H80-035811
340B ID
CH04168AH
Grant Number
H80CS00185
Additional Details
Current Program Status
Active
Registration Date
4/12/2023
Participating Start Date
7/1/2023
Participating Approval Date
4/12/2023
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
2450 Edison Ave
Fort Myers, FL 33901
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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April 2025
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