NPIMap

Organization Active NPI

Mercy Pharmacy Services, LLC

Doing business as Mercy Pharmacy Southfork

  • Community/Retail Pharmacy
  • Saint Louis, MO
National Provider Identifier
1568753150
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2012021200 Issued in MO
Legal business name
MERCY PHARMACY SERVICES, LLC
Doing business as
Mercy Pharmacy Southfork
Practice address
12700 Southfork Rd Ste 110
Saint Louis, MO 63128-3201
Phone
(314) 525-4488
Fax
(314) 525-4810
NPI assigned
Apr 29, 2011
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 2012021200 MO Primary

Addresses

Primary practice location

12700 Southfork Rd Ste 110
Saint Louis, MO 63128-3201

Mailing address

14528 S Outer 40 Rd Ste 100
Chesterfield, MO 63017-5743
Phone (314) 525-4488

Other identifiers 1

IdentifierTypeStateIssuer
2134979OtherPK

Other names 1

  • Mercy Pharmacy Southfork Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 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…
O20220104001566 MO DME Supplier - Pharmacy 3375815483 Practice locations: St Louis, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Mercy Pharmacy Southfork12700 Southfork Rd, St Louis, MO 63128-3276(314) 525-4488 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Jul 1, 2017

National Provider Directory

National Provider Directory
Tax ID family
Mercy Pharmacy Services LLC54 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

12700 Southfork Rd
Ste 110
Saint Louis, MO 63128
Phone (314) 525-4488

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1568753150",
    "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": "314-525-4488",
            "fax_number": "314-525-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 110",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-525-4488",
            "fax_number": "314-525-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY PHARMACY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-29",
        "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": "MO",
            "license": "2012021200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134979",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Pharmacy Southfork",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.