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General NPI Number Information
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NPI Number | 1760609671
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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 | 04/20/2007
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Last Update Date | 11/22/2021
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Provider Practice Location Address
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Address Line | 10010 KENNERLY RD FL 1
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2106
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Country | US
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Telephone | 314-525-1633
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Fax | 314-525-1634
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Provider Business Mailing Address
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Address Line | 10010 KENNERLY RD FL 1
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2106
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Country | US
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Telephone | 314-525-1633
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Fax | 314-525-1634
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Authorized Official
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Title or Position | VP AMBULATORY & SPECIALTY PHARMACY
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Name | MR. MARK JAEGER
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Credential |
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Telephone | 314-628-5607
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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 | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 000328
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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