Provider Demographics
NPI:1568729150
Name:MERCY HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:MERCY HEALTH SERVICES, LLC
Other - Org Name:MERCY PHARMACY - ST LOUIS LOBBY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER EAST COMMUNITY
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HYATT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:314-251-7445
Mailing Address - Street 1:615 S NEW BALLAS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8221
Mailing Address - Country:US
Mailing Address - Phone:314-251-6900
Mailing Address - Fax:314-251-6899
Practice Address - Street 1:615 S NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-251-6900
Practice Address - Fax:314-251-6899
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-19
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy