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DSH030014AB HONORHEALTH JOHN C. LINCOLN MED CTR (Active)
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Main Details
Name
HONORHEALTH JOHN C. LINCOLN MED CTR
Subdivision Name
Pulmonary Hypertension Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030014AB
Medicare Provider Number
030014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/3/2020
Participating Start Date
4/22/2020
Participating Approval Date
4/9/2020
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 #2030
Phoenix, AZ 85020
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
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