340B Drug Pricing Program Database
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RRC030092-00 HONORHEALTH DEER VALLEY MED CTR (Active)
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Main Details
Name
HONORHEALTH DEER VALLEY MED CTR
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC030092-00
Medicare Provider Number
030092
Additional Details
Current Program Status
Active
Registration Date
7/16/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/19/2017
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
19829 N 27th Ave
Phoenix, AZ 85027
Billing Address
HONORHEALTH DEER VALLEY MED CTR
PO Box 14890
Scottsdale, AZ 85267
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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