Healthcare Provider Details

I. General information

NPI: 1003748328
Provider Name (Legal Business Name): MERCY PHARMACY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3722 NEW TOWN BLVD
SAINT CHARLES MO
63301-4360
US

IV. Provider business mailing address

14528 S OUTER 40 RD
CHESTERFIELD MO
63017-5785
US

V. Phone/Fax

Practice location:
  • Phone: 314-628-5627
  • Fax:
Mailing address:
  • Phone: 314-628-5627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DOUG MALCOLM
Title or Position: VICE PRESIDENT
Credential:
Phone: 314-628-5607