Healthcare Provider Details

I. General information

NPI: 1609723154
Provider Name (Legal Business Name): ST MERCURIUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6150 PARKLAND BLVD STE 105
MAYFIELD HEIGHTS OH
44124-4103
US

IV. Provider business mailing address

6150 PARKLAND BLVD STE 105
MAYFIELD HEIGHTS OH
44124-4103
US

V. Phone/Fax

Practice location:
  • Phone: 216-899-7455
  • Fax: 216-899-7456
Mailing address:
  • Phone: 216-899-7455
  • Fax: 216-899-7456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: SHERIF MANKARYOUS
Title or Position: PHARMACY DIRECTOR
Credential: RPH
Phone: 440-725-9938