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General NPI Number Information
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NPI Number | 1568753150
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Entity Type | Organization
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Legal Business Name | MERCY PHARMACY SERVICES, LLC
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Dates
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Enumeration Date | 04/29/2011
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 12700 SOUTHFORK RD STE 110
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City | SAINT LOUIS
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State | MO
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Zip | 63128-3201
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Country | US
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Telephone | 314-525-4488
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Fax | 314-525-4810
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Provider Business Mailing Address
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Address Line | 14528 S OUTER 40 RD STE 100
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City | CHESTERFIELD
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State | MO
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Zip | 63017-5743
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Country | US
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Telephone | 314-525-4488
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Fax | 314-525-4810
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DOUG MALCOLM
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Credential | PHARMD, MHA
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Telephone | 303-813-5532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2012021200
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License Number State | MO
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