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NPI Code Detail

MEDICARE: MERCY PHARMACY SERVICES, LLC

MEDICARE: MERCY PHARMACY SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1417806555
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY PHARMACY SERVICES, LLC
Provider Business Mailing Address
First Line : 14528 S OUTER 40 RD STE 100
Second Line :
City : CHESTERFIELD
State : MO
Zip : 63017-5743
Country : US
Telephone Number : 314-628-5607
Fax Number :
Provider Business Practice Location Address
First Line : 2708 S RIFE MEDICAL LN STE 110
Second Line :
City : ROGERS
State : AR
Zip : 72758-1455
Country : US
Telephone Number : 479-338-2300
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : DOUG MALCOLM
Credential : PHARMD, MHA
Telephone Number : 303-813-5532
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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Directions to “MERCY PHARMACY SERVICES, LLC ” Practice Location

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