Provider Demographics
NPI:1710762257
Name:MERCY PHARMACY SERVICES, LLC
Entity Type:Organization
Organization Name:MERCY PHARMACY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGUALTORY COMPLIANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-628-5627
Mailing Address - Street 1:14528 S OUTER 40 RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5785
Mailing Address - Country:US
Mailing Address - Phone:146-285-6273
Mailing Address - Fax:
Practice Address - Street 1:212 HOSPITAL LN STE 102
Practice Address - Street 2:
Practice Address - City:PERRYVILLE
Practice Address - State:MO
Practice Address - Zip Code:63775-4204
Practice Address - Country:US
Practice Address - Phone:573-547-4960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY PHARMACY SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy