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DSH030014AH HONORHEALTH JOHN C. LINCOLN MED CTR (Active)
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Main Details
Name
HONORHEALTH JOHN C. LINCOLN MED CTR
Subdivision Name
HHRI Oncology Clinical Trials
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030014AH
Medicare Provider Number
030014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
6/1/2023
Participating Start Date
6/12/2023
Participating Approval Date
6/9/2023
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
10510 N 92nd St
Scottsdale, AZ 85258
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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