Organization
MERCY HOSPITAL SPRINGFIELD
Active
Other names
Mercy Pharmacy-Licking
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK BERRY (EXEC DIR-RETAIL PHARMACY SVCS)
(314) 628-5606
Entity
Organization
Contact information
Practice address
101 N MAIN ST, LICKING, MO 65542-9026
(573) 674-2922
(573) 674-4334
Mailing address
101 N MAIN ST, LICKING, MO 65542-9026
(573) 674-2922
(573) 674-4334
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
2011020758
MO
333600000X
Pharmacy
Primary
2011020758
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2608466
NCPDP #
MO
05
—
600054100
—
MO
Enumeration date
05/28/2006
Last updated
11/03/2017
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