Healthcare Provider Details

I. General information

NPI: 1649799560
Provider Name (Legal Business Name): MERCY PHARMACY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2017
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 S FREMONT AVE STE 5200
SPRINGFIELD MO
65804-2239
US

IV. Provider business mailing address

14528 S OUTER 40 RD STE 100
CHESTERFIELD MO
63017-5743
US

V. Phone/Fax

Practice location:
  • Phone: 417-820-7099
  • Fax: 417-820-8178
Mailing address:
  • Phone: 314-628-5627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number StateMO
# 6
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateMO
# 7
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

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