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
1	3336C0003X	Community/Retail Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336S0011X	Specialty Pharmacy

General Provider Information

NPI Number	:	1699294629
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERCY PHARMACY SERVICES, LLC

Provider Business Mailing Address
First Line	:	645 MARYVILLE CENTRE DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-5855
Country	:	US
Telephone Number	:	314-364-2245
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 MCAULEY BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-8341
Country	:	US
Telephone Number	:	405-486-8727
Fax Number	:	405-486-8728

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DOUG MALCOLM
Credential	:	PHARMD, MHA
Telephone Number	:	303-813-5532

Provider Enumeration Date	:	09/11/2017
Last Update Date	:	01/26/2026

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