Healthcare Provider Details

I. General information

NPI: 1447550132
Provider Name (Legal Business Name): ACCREDO HEALTH GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 ROUTE 46 EAST SUITE 609
PINE BROOK NJ
07058-9390
US

IV. Provider business mailing address

PO BOX 954041
SAINT LOUIS MO
63195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 973-276-0794
  • Fax: 973-276-0998
Mailing address:
  • Phone: 901-381-7141
  • Fax: 901-261-6924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00661300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VIC PERINI
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 314-684-6273