340B Drug Pricing Program Database
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DSH030014S HONORHEALTH JOHN C. LINCOLN MED CTR (Active)
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Main Details
Name
HONORHEALTH JOHN C. LINCOLN MED CTR
Subdivision Name
HonorHealth Cancer Care - Avondale
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030014S
Medicare Provider Number
030014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/3/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/11/2018
Last Recertification Date
8/20/2024
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
10320 W McDowell Rd Bldg H
Avondale, AZ 85392
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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