NPIMap

Organization Active NPI

Mercy Health Services, LLC

  • Pharmacy
  • Saint Louis, MO
National Provider Identifier
1689665077
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
2005000851 Issued in MO
Legal business name
MERCY HEALTH SERVICES, LLC
Practice address
12680 Olive Blvd
Suite #150
Saint Louis, MO 63141-6322
Phone
(314) 251-8989
Fax
(314) 251-8988
NPI assigned
Nov 3, 2005
Last updated
Nov 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2017

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

Authorized official

Name
Patrick Berry
Title
Exec Dir-Retail Pharmacy SVCS
Phone
(314) 628-5606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 2005000851 MO Primary

Addresses

Primary practice location

12680 Olive Blvd
Suite #150
Saint Louis, MO 63141-6322

Mailing address

12680 Olive Blvd
Suite #150
Saint Louis, MO 63141-6322
Phone (314) 251-8989

Other identifiers 2

IdentifierTypeStateIssuer
2635881OtherMONCPDP
606186609MedicaidMO

National Provider Directory

National Provider Directory

Locations

12680 Olive Blvd
Ste 150
Saint Louis, MO 63141
Phone (314) 251-8989

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510272000000",
    "number": "1689665077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12680 OLIVE BLVD",
            "address_2": "SUITE #150",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416322",
            "telephone_number": "314-251-8989",
            "fax_number": "314-251-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12680 OLIVE BLVD",
            "address_2": "SUITE #150",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416322",
            "telephone_number": "314-251-8989",
            "fax_number": "314-251-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2017-11-10",
        "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"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MO",
            "license": "2005000851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2635881",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606186609",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 10, 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.