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DSH100012CD LEE MEMORIAL HEALTH SYSTEM DBA LEE MEMORIAL HOSPITAL (Active)
Main Details
Name
LEE MEMORIAL HEALTH SYSTEM DBA LEE MEMORIAL HOSPITAL
Subdivision Name
Regional Cancer Center - Radiology- PET SCAN
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100012CD
Medicare Provider Number
100012
Outpatient Facility Provider Number
Contacts
Authorizing Official
Lee Memorial Health System
Benjamin Spence, CFO
(239) 343-6014
Primary Contact
Lee Memorial Health System
Joseph Bitner, Compliance Officer
(239) 343-8602
Additional Details
Current Program Status
Active
Registration Date
10/12/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/1/2023
Last Recertification Date
Addresses
Street Address
8931 Colonial Center Drive
101
Fort Myers, FL 33905
Billing Address
Lee Memorial Health System DBA Lee Memorial Hospital
2776 Cleveland Avenue
Fort Myers, FL 33901
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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