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RRC030038-00 HONORHEALTH SCOTTSDALE OSBORN MED CT (Terminated)
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Main Details
Name
HONORHEALTH SCOTTSDALE OSBORN MED CT
Subdivision Name
Type
Rural Referral Center
Rural
No
340B ID
RRC030038-00
Medicare Provider Number
030038
Additional Details
Current Program Status
Terminated
Registration Date
6/10/2019
Participating Start Date
7/1/2019
Participating Approval Date
6/12/2019
Last Recertification Date
8/23/2023
Termination Date
Termination Reason
7/1/2024
DSH percentage below statutory minimum
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
7400 E Osborn Rd
Scottsdale, AZ 85251
Billing Address
HONORHEALTH SCOTTSDALE OSBORN MED CT
PO Box 14890
Scottsdale, AZ 85267
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 7/1/2017, terminated 10/1/2018. Reinstated 7/1/2019.
06/12/2019
April 2025
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