# PRIME HEALTHCARE SERVICES - SAINT JOHN LEAVENWORTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Saint John Primary Care Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912875600
- **Authorized official:** CHRISTOPHER DOAN (MANAGING ASSOCIATE GENERAL COUNSEL)
- **Authorized official phone:** (310) 259-4706

## Contact information

- **Practice address:** 3550 S 4TH ST STE 200, LEAVENWORTH, KS 66048-5009
- **Practice address phone:** (913) 680-6442
- **Practice address fax:** (913) 680-6425
- **Mailing address:** 3550 S 4TH ST STE 200, LEAVENWORTH, KS 66048-5009
- **Mailing address phone:** (913) 680-6442
- **Mailing address fax:** (913) 680-6425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/25/2025
- **Last updated:** 10/25/2025