Healthcare Provider Details

I. General information

NPI: 1760609671
Provider Name (Legal Business Name): MERCY PHARMACY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 KENNERLY RD FL 1
SAINT LOUIS MO
63128-2106
US

IV. Provider business mailing address

14528 S OUTER 40 RD
CHESTERFIELD MO
63017-5785
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-1633
  • Fax: 314-525-1634
Mailing address:
  • Phone: 314-628-5627
  • Fax: 314-525-1634

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
# 3
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number000328
License Number StateMO

VIII. Authorized Official

Name: DOUG MALCOLM
Title or Position: VICE PRESIDENT
Credential: PHARMD, MHA
Phone: 303-813-5532