NPIMap

Organization Active NPI

Mercy Pharmacy Services, LLC

Doing business as Mercy Pharmacy Tower OKC

  • Community/Retail Pharmacy
  • Oklahoma City, OK
National Provider Identifier
1104910363
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1-6150 Issued in OK
Legal business name
MERCY PHARMACY SERVICES, LLC
Doing business as
Mercy Pharmacy Tower OKC
Practice address
4200 W Memorial Rd
Suite 106
Oklahoma City, OK 73120-9350
Phone
(405) 752-3590
Fax
(405) 752-3885
NPI assigned
Oct 3, 2006
Last updated
Jan 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Authorized official

Name
Doug Malcolm, PHARMD, MHA
Title
Vice President
Phone
(303) 813-5532

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 1-6150 OK Primary
Mail Order Pharmacy 3336M0002X NU
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

4200 W Memorial Rd
Suite 106
Oklahoma City, OK 73120-9350

Mailing address

14528 S Outer 40 Rd Ste 100
Chesterfield, MO 63017-5743
Phone (314) 628-5627

Other identifiers 2

IdentifierTypeStateIssuer
100699390GMedicaidOK
2074206OtherPK

Other names 1

  • Mercy Pharmacy Tower OKC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170824002384 MO Part B Supplier - Mass Immunization (Roster Biller Only) 3375815483 This NPI is an additional NPI on the enrollment
Practice locations: Rolla, MO; Saint Louis, MO; Saint Charles, MO; Saint Peters, MO; Saint Robert, MO; Sappington, MO; Springfield, MO; St Louis, MO…
O20250326000186 OK Part B Supplier - Mass Immunization (Roster Biller Only) 3375815483 5 other NPIs on this enrollment
Practice locations: Yukon, OK; Oklahoma City, OK; Edmond, OK; Ardmore, OK

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

4200 W Memorial Rd
Ste 106
Oklahoma City, OK 73120
Phone (405) 752-3590

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1104910363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14528 S OUTER 40 RD STE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175743",
            "telephone_number": "314-628-5627",
            "fax_number": "405-752-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD",
            "address_2": "SUITE 106",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209350",
            "telephone_number": "405-752-3590",
            "fax_number": "405-752-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY PHARMACY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A",
        "authorized_official_last_name": "MALCOLM",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "303-813-5532",
        "authorized_official_credential": "PHARMD, MHA"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "1-6150",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699390G",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2074206",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Pharmacy Tower OKC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; 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.