| NPI | 1104910363 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-10-03 |
| Last Updated | 2026-01-26 |
| Authorized Official | Doug Malcolm Vice President Phone: 3038135532 |
| Mailing Address | 14528 S Outer 40 Rd Ste 100 Chesterfield, MO 63017-5743 United States Phone: (314) 628-5627 | Fax: (405) 752-3885 📍 View Map |
| Primary Practice Address | 4200 W Memorial Rd, Suite 106 Oklahoma City, OK 73120-9350 United States Phone: (405) 752-3590 | Fax: (405) 752-3885 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | OK | 100699390G | - |
| Other (non-Medicare) | - | 2074206 | PK |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 3336C0004X – Pharmacy, Compounding Pharmacy | - | - |
| No | 3336M0002X – Pharmacy, Mail Order Pharmacy | - | - |
| No | 333600000X – Pharmacy | - | - |
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | OK | 1-6150 |
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About NPI 1104910363
Mercy Pharmacy Services, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1104910363. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Oklahoma City, OK. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-10-03. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1104910363?
NPI 1104910363 belongs to Mercy Pharmacy Services, Llc, a Pharmacy, Community/Retail Pharmacy in Oklahoma City, OK. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1104910363 active?
The current status of NPI 1104910363 in the NPPES registry is Active. The record was last updated on 2026-01-26.
What specialty is NPI 1104910363?
NPI 1104910363 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1104910363?
You can verify NPI 1104910363 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1104910363?
The primary practice address on file for NPI 1104910363 is 4200 W Memorial Rd, Oklahoma City, OK 73120-9350. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1104910363 issued?
NPI 1104910363 was first issued (enumerated) on 2006-10-03. The NPPES record was last updated on 2026-01-26.
Practice Location Map
Mercy Pharmacy Services, Llc is located at 4200 W Memorial Rd, Oklahoma City, OK. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Mercy Pharmacy Services, Llc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1104910363. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | 1-6150 | OK |