Organization
LEE MEMORIAL HEALTH SYSTEM
Active
Other names
Gulf Coast Medical Center, Lee Pharmacy 3
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN SPENCE (CHEIF FINANCIAL OFFICER)
(239) 343-6012
Entity
Organization
Contact information
Practice address
13681 DOCTORS WAY, FORT MYERS, FL 33912-4300
(239) 424-1503
Mailing address
PO BOX 150107, CAPE CORAL, FL 33915-0107
(239) 424-1503
(239) 424-1599
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000035955
HUMANA
FL
05
—
000443286X
—
GA
01
—
0082074
AETNA
—
05
—
011134100
—
FL
05
—
01637067
—
NY
01
—
035577800
BLACK LUNG
—
05
—
2072402
—
OH
01
—
20944
WELLCARE/STAYWELL
—
05
—
304861581
—
MI
01
—
568
BLUE CROSS
FL
05
—
9810088000
—
WV
Enumeration date
05/20/2006
Last updated
10/10/2018
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