Provider Demographics
NPI:1770690695
Name:HONORHEALTH
Entity Type:Organization
Organization Name:HONORHEALTH
Other - Org Name:HONORHEALTH JOHN C. LINCOLN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR NETWORK DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-683-4503
Mailing Address - Street 1:250 E DUNLAP AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2825
Mailing Address - Country:US
Mailing Address - Phone:602-870-6304
Mailing Address - Fax:602-944-9610
Practice Address - Street 1:250 E DUNLAP AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2825
Practice Address - Country:US
Practice Address - Phone:602-870-6304
Practice Address - Fax:602-944-9610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH0077282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0676381OtherAETNA HEALTH INC.
AZ446246Medicaid
AZ860117301OtherDONOR NETWORK OF AZ
AZ860117301OtherCOMMUNITY CARE NETWORK
AZ860117301OtherAZ DEPT OF JUVENILLE CORR
AZBS00702OtherUNITED WEST LABS
AZAZ0204830OtherBLUE CROSS
AZ860117301OtherHEALTH MGMT NETWORK
AZ860117301OtherAZ FOUNDATION FOR MED CAR
AZ860117301OtherBEECH STREET
AZ860117301OtherFIRST HEALTH
AZ0000OtherBLUE CROSS TRICARE
AZ860117301OtherCHOICE CARE NETWORK
AZ860117301OtherACCOUNTABLE HEALTH PLANS
AZ860117301OtherFEDERAL CORRECTIONAL INST
AZ020181Medicaid
AZ860117301OtherCITY OF GLENDALE WORKERS
AZ860117301OtherAZ STATE PHYS ASSOC
AZ860117301OtherFEDERAL CORRECTIONAL INST
AZ030014Medicare ID - Type Unspecified