NPIMap

Organization Active NPI

Mercy Pharmacy Services, LLC

  • Community/Retail Pharmacy
  • Lebanon, MO
National Provider Identifier
1710404264
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2017027482 Issued in MO
Legal business name
MERCY PHARMACY SERVICES, LLC
Practice address
200 Hospital Dr
Lebanon, MO 65536-9215
Phone
(417) 533-6770
NPI assigned
Aug 25, 2017
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
Community/Retail Pharmacy 3336C0003X 2017027482 MO Primary

Addresses

Primary practice location

200 Hospital Dr
Lebanon, MO 65536-9215

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
2049004OtherPK
600095004MedicaidMO

Other names 1

  • Mercy Pharmacy Lebanon 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 Practice locations: Rolla, MO; Saint Louis, MO; Saint Charles, MO; Saint Peters, MO; Saint Robert, MO; Sappington, MO; Springfield, MO; St Louis, MO…
O20171212000514 MO DME Supplier - Pharmacy 3375815483 Practice locations: Lebanon, 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": "1710404264",
    "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": "200 HOSPITAL DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655369215",
            "telephone_number": "417-533-6770"
        }
    ],
    "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2017027482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049004",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600095004",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Pharmacy Lebanon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercy Pharmacy Lebanon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, 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.