NPIMap

Organization Active NPI

Saint Joseph's Mercy Care Services, Inc.

Doing business as Mercy Care Pharmacy

  • Community/Retail Pharmacy
  • Atlanta, GA
National Provider Identifier
1487199972
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE010329 Issued in GA
Legal business name
SAINT JOSEPH'S MERCY CARE SERVICES, INC.
Doing business as
Mercy Care Pharmacy
Practice address
424 Decatur Street NE
Suite 100
Atlanta, GA 30303
Phone
(404) 439-0949
Fax
(614) 652-0785
NPI assigned
Dec 20, 2016
Last updated
Oct 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Authorized official

Name
Ms. Pearly Ittickathra
Title
Chief of Care Delivery
Phone
(678) 843-8654

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X PHRE010329 GA Primary

Addresses

Primary practice location

424 Decatur Street NE
Suite 100
Atlanta, GA 30303

Mailing address

424 Decatur St SE
Atlanta, GA 30312-1848
Phone (678) 843-8654

Other names 1

  • Mercy Care Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250109003816 GA Part B Supplier - Mass Immunization (Roster Biller Only) 4688961501 Practice locations: Atlanta, GA

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Central Health Center13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

424 Decatur St SE
Atlanta, GA 30312
Phone (678) 843-8500

424 Decatur St SE
Ste 100
Atlanta, GA 30312
Phone (404) 308-5637

Practitioners & affiliated clinicians

Practitioners 1

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": "1482192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759276800000",
    "number": "1487199972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 DECATUR ST SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303121848",
            "telephone_number": "678-843-8654",
            "fax_number": "404-588-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 DECATUR STREET NE",
            "address_2": "SUITE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30303",
            "telephone_number": "404-439-0949",
            "fax_number": "614-652-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT JOSEPH'S MERCY CARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-20",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "ITTICKATHRA",
        "authorized_official_first_name": "PEARLY",
        "authorized_official_title_or_position": "CHIEF OF CARE DELIVERY",
        "authorized_official_telephone_number": "678-843-8654",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.