NPIMap

Organization Active NPI

Mercy Pharmacy Services, LLC

Doing business as Mercy Pharmacy Rolla

  • Community/Retail Pharmacy
  • Rolla, MO
National Provider Identifier
1568989028
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2017027484 Issued in MO
Legal business name
MERCY PHARMACY SERVICES, LLC
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
Aug 25, 2017
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 2017027484 MO Primary

Addresses

Primary practice location

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

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
606187300MedicaidMO
2637114OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • MERCY PHARMACY ROLLA 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…
O20171227001447 MO DME Supplier - Pharmacy 3375815483 Practice locations: Rolla, MO

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.

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1568989028",
    "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"
        },
        {
            "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 PHARMACY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-25",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2017027484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606187300",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2637114",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY PHARMACY ROLLA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MERCY PHARMACY ROLLA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolla, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.