Provider Demographics
NPI:1083206486
Name:MERCY PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:MERCY PHARMACY SERVICES LLC
Other - Org Name:MERCY PHARMACY BRENTWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PHARMACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-628-3406
Mailing Address - Street 1:8450 EAGER RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63144-1413
Mailing Address - Country:US
Mailing Address - Phone:314-962-9036
Mailing Address - Fax:
Practice Address - Street 1:8450 EAGER RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:MO
Practice Address - Zip Code:63144-1413
Practice Address - Country:US
Practice Address - Phone:314-962-9036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-07
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy