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DSH030014C HONORHEALTH JOHN C. LINCOLN MED CTR (Active)
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Main Details
Name
HONORHEALTH JOHN C. LINCOLN MED CTR
Subdivision Name
OR Outpatient Surgery
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030014C
Medicare Provider Number
030014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/29/2015
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
HonorHealth
Lisa Montman, SVP/CFO
(480) 587-5120
Primary Contact
HonorHealth
Kristjon Lindgren, 340B Program Director
(602) 793-5509
Addresses
Street Address
9250 N 3rd St #1001
Phoenix, AZ 85020-2412
Billing Address
HONORHEALTH JOHN C. LINCOLN MED CTR
PO Box 14890
Scottsdale, AZ 85267
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
May 2025
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