Mercury Pharmacy Services Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

MERCURY PHARMACY SERVICES INC

Practice address

22316 70TH Ave W Ste E
Mountlake Terrace, WA 98043-2184

Phone

(425) 673-5200

Fax

(425) 673-5230

NPI assigned

Jan 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephen Lawrence Boulanger, RPHNPI 1902847296

Title

Pharmacist in Charge

Phone

(425) 673-5200

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 2

• Mercury Pharmacy Services Doing business as
• Mercury Pharmacy Services INC Doing business as

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Guardian Pharmacy of Washington, LLC

  • Long Term Care Pharmacy
  • Mountlake Terrace, WA
  • NPI 1790653798

  Member Of

  NPD member

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephen Lawrence Boulanger, RPH.

  • Pharmacist
  • Mountlake Terrace, WA
  • NPI 1902847296
  NPD Authorized official
• Pavel Conovalciuc, MD

  • Family Medicine Physician
  • Spokane Valley, WA
  • NPI 1720017080
  NPD
• Sarah Wue, PHARMD

  • Pharmacist
  • Mountlake Terrace, WA
  • NPI 1003330481
  NPD
• Vuk Kovacevic, PHARMD

  • Pharmacist
  • Mountlake Terrace, WA
  • NPI 1700438421
  NPD (past)
• Katherine Nguyen

  • Pharmacist
  • Mountlake Terrace, WA
  • NPI 1710546031
  NPD (past)
• Grant Walker, PHARM.D.

  • Geriatric Pharmacist
  • Mountlake Terrace, WA
  • NPI 1063752384
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1073659694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22316 70TH AVE W STE E5",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432184",
            "telephone_number": "425-673-5200",
            "fax_number": "425-673-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22316 70TH AVE W STE E",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432184",
            "telephone_number": "425-673-5200",
            "fax_number": "425-673-5230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22316 70th Ave W Ste E",
            "address_purpose": "LOCATION",
            "city": "Mountlake Terrace",
            "state": "WA",
            "postal_code": "980432184",
            "country_code": "US",
            "telephone_number": "425-673-5200 x303",
            "fax_number": "425-673-5230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MERCURY PHARMACY SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "BOULANGER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "425-673-5200",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6024343",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4925321",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "PHARCF60832484",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercury Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercury Pharmacy Services INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeannine Meadowcroft, LMP
• Michelle Elaine Meako, ARNP
• Christine Gale Meeker
• Zelda Menard
• Muneera Merchant, DDS
• Jeffrey Don Meyer, DPT
• Laura Meyer, LMHCA
• Emily Ruth Lovelett Meyerson, L.M.P.
• Michael E. Hrankowski, DDS, PLLC
• Tracey Anne Middleton, LCSW-C

• Long Term Care Pharmacy in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Long Term Care Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.