Healthcare Provider Details
I. General information
NPI: 1659704617
Provider Name (Legal Business Name): ACCREDO HEALTH GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/14/2013
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2051 OLD COOCHS BRIDGE RD STE 100
NEWARK DE
19702-2483
US
IV. Provider business mailing address
PO BOX 954041
SAINT LOUIS MO
63195-0001
US
V. Phone/Fax
- Phone: 302-395-8943
- Fax:
- Phone: 901-381-7141
- Fax: 901-261-6924
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336M0002X |
| Taxonomy | Mail Order Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | A3-0000986 |
| License Number State | DE |
VIII. Authorized Official
Name:
VICTOR
JOSEPH
PERINI
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 314-684-6750