Provider Demographics
NPI:1023600434
Name:MERCY PHARMACY SERVICES LLC
Entity type:Organization
Organization Name:MERCY PHARMACY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACY OFFIER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-628-3406
Mailing Address - Street 1:1730 CLARKSON RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-4976
Mailing Address - Country:US
Mailing Address - Phone:636-537-9408
Mailing Address - Fax:636-530-3012
Practice Address - Street 1:1730 CLARKSON RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4976
Practice Address - Country:US
Practice Address - Phone:636-537-9408
Practice Address - Fax:636-530-3012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-07
Last Update Date:2021-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy