Healthcare Provider Details

I. General information

NPI: 1942863972
Provider Name (Legal Business Name): ACCREDO HEALTH GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 ALA MOANA BLVD SUITE 404
HONOLULU HI
96813-5412
US

IV. Provider business mailing address

1 EXPRESS WAY
SAINT LOUIS MO
63121-1824
US

V. Phone/Fax

Practice location:
  • Phone: 800-650-6488
  • Fax:
Mailing address:
  • Phone: 314-684-6702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: VICTOR JOSEPH PERINI
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 314-847-0146