Mercy Hospital Springfield

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2006022821 Issued in MO

Legal business name

MERCY HOSPITAL SPRINGFIELD

Doing business as

Mercy Pharmacy-Rolla

Practice address

1605 Martin Springs Dr Ste 220
Rolla, MO 65401-2980

Phone

(573) 458-6433

Fax

(573) 458-6441

NPI assigned

Sep 21, 2006

Last updated

Nov 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Patrick Berry

Title

Exec Dir-Retail Pharmacy SVCS

Phone

(314) 628-5606

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mercy Pharmacy-Rolla Doing business as

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509494400000",
    "number": "1306944301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 MARTIN SPRINGS DR",
            "address_2": "SUITE 220",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012931",
            "telephone_number": "573-458-6433",
            "fax_number": "573-458-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 MARTIN SPRINGS DR STE 220",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012980",
            "telephone_number": "573-458-6433",
            "fax_number": "573-458-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL SPRINGFIELD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "EXEC DIR-RETAIL PHARMACY SVCS",
        "authorized_official_telephone_number": "314-628-5606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2006022821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2637114",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606187300",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Pharmacy-Rolla",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mercy Clinic-Springfield Communities (Mercy Clinic Family Medicine - Rolla)
• Mercy Hospital Lebanon (Mercy Surgery Center-Lebanon at Rolla)
• Mercy Hospital Lebanon
• Mercy Hospital Lebanon
• Mercy Hospital Springfield (Mercy Medical Supply)
• Mercy Pharmacy Services, LLC (Mercy Pharmacy Rolla)
• Derrick Meyers, PHD, BA
• Mi Serenity
• Nathan Micklautz, CRNA
• Mid-Missouri Foot and Ankle Center (Anderson Foot Clinic)

• Community/Retail Pharmacy in Rolla, MO
• Providers in Rolla, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.