Provider Demographics
NPI:1598529927
Name:MERCY PHARMACY SERVICES, LLC
Entity Type:Organization
Organization Name:MERCY PHARMACY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:JAEGER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, MBA, MHA
Authorized Official - Phone:314-628-5607
Mailing Address - Street 1:14528 S OUTER 40 RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5743
Mailing Address - Country:US
Mailing Address - Phone:314-628-5627
Mailing Address - Fax:
Practice Address - Street 1:817 S MOUNT AUBURN RD STE 130
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-6392
Practice Address - Country:US
Practice Address - Phone:573-519-4550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy