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CH04170Z COLLIER HEALTH SERVICES INC (Terminated)
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Main Details
Name
COLLIER HEALTH SERVICES INC
Subdivision Name
Healthcare Network Apple Pediatrics
Type
HRSA-Funded Health Center
Site ID
BPS-H80-037037
340B ID
CH04170Z
Grant Number
H80CS00735
Additional Details
Current Program Status
Terminated
Registration Date
8/16/2023
Participating Start Date
10/1/2023
Participating Approval Date
8/21/2023
Last Recertification Date
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Collier Health Services, Inc., d/b/a Healthcare Network
John Fletcher, Chief Operating Officer & General Counsel
(239) 658-3060
Primary Contact
Collier Health Services, Inc.
Martine Woolley, Vice President of Pharmacy
(239) 658-3030
Addresses
Street Address
7795 Davis Blvd, Ste 206
Naples, FL 34104-5373
Billing Address
Healthcare Network
1454 Madison Ave W
Immokalee, FL 34142
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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