Organization
PRIME HEALTHCARE SERVICES - LEAVENWORTH SURGERY CENTER, LLC
Active
Other names
Saint John Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL G NYP (CHIEF EXECUTIVE OFFICER)
(913) 596-3930
Entity
Organization
Contact information
Practice address
3550 S 4TH ST, SUITE G1, LEAVENWORTH, KS 66048-5071
(913) 680-6400
Mailing address
3500 S 4TH ST, LEAVENWORTH, KS 66048-5043
(913) 680-6400
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
KS
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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